{ "hospital_name": "St Marys Medical Center", "last_updated_on": "2025-12-09","version": "2.2.0", "hospital_location": ["St Marys Medical Center"],"hospital_address": [ "201 Northwest R.D. Mize Road Blue Springs, MO 64014" ], "license_information": { "license_number": "472264005", "state": "MO" }, "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": "Hc Liver Dis 10 Assays W/Nash", "code_information": [ { "code": "0003M", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2670.29, "discounted_cash": 654,"minimum": 453.06,"maximum": 2670.29,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 525.55, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2002.72, "standard_charge_percentage": 75.0000, "estimated_amount": 2002, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2002.72, "standard_charge_percentage": 75.0000, "estimated_amount": 2002, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1335.14, "standard_charge_percentage": 50.0000, "estimated_amount": 1335, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1068.12, "standard_charge_percentage": 40.0000, "estimated_amount": 1068, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2336.5, "standard_charge_percentage": 87.5000, "estimated_amount": 2336, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2136.23, "standard_charge_percentage": 80.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2670.29, "standard_charge_percentage": 100.0000, "estimated_amount": 2670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2136.23, "standard_charge_percentage": 80.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2136.23, "standard_charge_percentage": 80.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1869.2, "standard_charge_percentage": 70.0000, "estimated_amount": 1869, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2189.64, "standard_charge_percentage": 82.0000, "estimated_amount": 2189, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1548.77, "standard_charge_percentage": 58.0000, "estimated_amount": 1548, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2403.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 513.47, "estimated_amount": 513, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 805.44, "estimated_amount": 805, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 704.76, "estimated_amount": 704, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1006.8, "estimated_amount": 1006, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 656.94, "estimated_amount": 656, "methodology": "fee schedule" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2670.29, "standard_charge_percentage": 100.0000, "estimated_amount": 2670, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1495.36, "standard_charge_percentage": 56.0000, "estimated_amount": 1495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2136.23, "standard_charge_percentage": 80.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2403.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 704.76, "estimated_amount": 704, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 679.59, "estimated_amount": 679, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 528.57, "estimated_amount": 528, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 652.41, "estimated_amount": 652, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 453.06, "estimated_amount": 453, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 647.88, "estimated_amount": 647, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 875.92, "estimated_amount": 875, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2403.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2403, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2403.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2403, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2269.75, "standard_charge_percentage": 85.0000, "estimated_amount": 2269, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2136.23, "standard_charge_percentage": 80.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2536.78, "standard_charge_percentage": 95.0000, "estimated_amount": 2536, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2136.23, "standard_charge_percentage": 80.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 801.09, "standard_charge_percentage": 30.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2002.72, "standard_charge_percentage": 75.0000, "estimated_amount": 2002, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1869.2, "standard_charge_percentage": 70.0000, "estimated_amount": 1869, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1869.2, "standard_charge_percentage": 70.0000, "estimated_amount": 1869, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2002.72, "standard_charge_percentage": 75.0000, "estimated_amount": 2002, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1602.17, "standard_charge_percentage": 60.0000, "estimated_amount": 1602, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 528.57, "estimated_amount": 528, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 453.06, "estimated_amount": 453, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2136.23, "standard_charge_percentage": 80.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2136.23, "standard_charge_percentage": 80.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2403.26, "standard_charge_percentage": 90.0000, "estimated_amount": 2403, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2336.5, "standard_charge_percentage": 87.5000, "estimated_amount": 2336, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2136.23, "standard_charge_percentage": 80.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1602.17, "standard_charge_percentage": 60.0000, "estimated_amount": 1602, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2136.23, "standard_charge_percentage": 80.0000, "estimated_amount": 2136, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2002.72, "standard_charge_percentage": 75.0000, "estimated_amount": 2002, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 988.01, "standard_charge_percentage": 37.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2616.88, "standard_charge_percentage": 98.0000, "estimated_amount": 2616, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 453.06, "estimated_amount": 453, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 503.4, "estimated_amount": 503, "methodology": "fee schedule" }]}]} , { "description": "Hc Cerbral Perfusion Study, Ct W/ Contrast", "code_information": [ { "code": "0042T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3079.52,"minimum": 923.86,"maximum": 3079.52,"payers_information":[{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2694.58, "standard_charge_percentage": 87.5000, "estimated_amount": 2694, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2463.62, "standard_charge_percentage": 80.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2463.62, "standard_charge_percentage": 80.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3079.52, "standard_charge_percentage": 100.0000, "estimated_amount": 3079, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2463.62, "standard_charge_percentage": 80.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1786.12, "standard_charge_percentage": 58.0000, "estimated_amount": 1786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2463.62, "standard_charge_percentage": 80.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1847.71, "standard_charge_percentage": 60.0000, "estimated_amount": 1847, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2463.62, "standard_charge_percentage": 80.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2309.64, "standard_charge_percentage": 75.0000, "estimated_amount": 2309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2463.62, "standard_charge_percentage": 80.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2771.57, "standard_charge_percentage": 90.0000, "estimated_amount": 2771, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2771.57, "standard_charge_percentage": 90.0000, "estimated_amount": 2771, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1847.71, "standard_charge_percentage": 60.0000, "estimated_amount": 1847, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2463.62, "standard_charge_percentage": 80.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 923.86, "standard_charge_percentage": 30.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2309.64, "standard_charge_percentage": 75.0000, "estimated_amount": 2309, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2771.57, "standard_charge_percentage": 90.0000, "estimated_amount": 2771, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2771.57, "standard_charge_percentage": 90.0000, "estimated_amount": 2771, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3017.93, "standard_charge_percentage": 98.0000, "estimated_amount": 3017, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2309.64, "standard_charge_percentage": 75.0000, "estimated_amount": 2309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1539.76, "standard_charge_percentage": 50.0000, "estimated_amount": 1539, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1539.76, "standard_charge_percentage": 50.0000, "estimated_amount": 1539, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2771.57, "standard_charge_percentage": 90.0000, "estimated_amount": 2771, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2617.59, "standard_charge_percentage": 85.0000, "estimated_amount": 2617, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2694.58, "standard_charge_percentage": 87.5000, "estimated_amount": 2694, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2463.62, "standard_charge_percentage": 80.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2309.64, "standard_charge_percentage": 75.0000, "estimated_amount": 2309, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2155.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2155, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2525.21, "standard_charge_percentage": 82.0000, "estimated_amount": 2525, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2309.64, "standard_charge_percentage": 75.0000, "estimated_amount": 2309, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1231.81, "standard_charge_percentage": 40.0000, "estimated_amount": 1231, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2463.62, "standard_charge_percentage": 80.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2925.54, "standard_charge_percentage": 95.0000, "estimated_amount": 2925, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3079.52, "standard_charge_percentage": 100.0000, "estimated_amount": 3079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2463.62, "standard_charge_percentage": 80.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2155.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2155, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2155.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2155, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1724.53, "standard_charge_percentage": 56.0000, "estimated_amount": 1724, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1139.42, "standard_charge_percentage": 37.0000, "estimated_amount": 1139, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "0232T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18158.7, "discounted_cash": 487,"minimum": 375.38,"maximum": 18158.7,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 13619, "standard_charge_percentage": 75.0000, "estimated_amount": 13619, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 14527, "standard_charge_percentage": 80.0000, "estimated_amount": 14526, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 18158.7, "standard_charge_percentage": 100.0000, "estimated_amount": 18158, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14527, "standard_charge_percentage": 80.0000, "estimated_amount": 14526, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 14527, "standard_charge_percentage": 80.0000, "estimated_amount": 14526, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 13619, "standard_charge_percentage": 75.0000, "estimated_amount": 13619, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 12711.1, "standard_charge_percentage": 70.0000, "estimated_amount": 12711, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 13619, "standard_charge_percentage": 75.0000, "estimated_amount": 13619, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 14890.2, "standard_charge_percentage": 82.0000, "estimated_amount": 14890, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10168.9, "standard_charge_percentage": 56.0000, "estimated_amount": 10168, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 10532.1, "standard_charge_percentage": 58.0000, "estimated_amount": 10532, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14527, "standard_charge_percentage": 80.0000, "estimated_amount": 14526, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 13619, "standard_charge_percentage": 75.0000, "estimated_amount": 13619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 10895.2, "standard_charge_percentage": 60.0000, "estimated_amount": 10895, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 382.89, "estimated_amount": 382, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 694.45, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 750.76, "estimated_amount": 750, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9079.36, "standard_charge_percentage": 50.0000, "estimated_amount": 9079, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 15434.9, "standard_charge_percentage": 85.0000, "estimated_amount": 15434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 15888.9, "standard_charge_percentage": 87.5000, "estimated_amount": 15888, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 15888.9, "standard_charge_percentage": 87.5000, "estimated_amount": 15888, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 14527, "standard_charge_percentage": 80.0000, "estimated_amount": 14526, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 17250.8, "standard_charge_percentage": 95.0000, "estimated_amount": 17250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5447.62, "standard_charge_percentage": 30.0000, "estimated_amount": 5447, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 12711.1, "standard_charge_percentage": 70.0000, "estimated_amount": 12711, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 12711.1, "standard_charge_percentage": 70.0000, "estimated_amount": 12711, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 6718.73, "standard_charge_percentage": 37.0000, "estimated_amount": 6718, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 16342.9, "standard_charge_percentage": 90.0000, "estimated_amount": 16342, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 17795.5, "standard_charge_percentage": 98.0000, "estimated_amount": 17795, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 600.61, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14527, "standard_charge_percentage": 80.0000, "estimated_amount": 14526, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 16342.9, "standard_charge_percentage": 90.0000, "estimated_amount": 16342, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 18158.7, "standard_charge_percentage": 100.0000, "estimated_amount": 18158, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 14527, "standard_charge_percentage": 80.0000, "estimated_amount": 14526, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 16342.9, "standard_charge_percentage": 90.0000, "estimated_amount": 16342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 600.61, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 13619, "standard_charge_percentage": 75.0000, "estimated_amount": 13619, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 14527, "standard_charge_percentage": 80.0000, "estimated_amount": 14526, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 16342.9, "standard_charge_percentage": 90.0000, "estimated_amount": 16342, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 16342.9, "standard_charge_percentage": 90.0000, "estimated_amount": 16342, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7263.49, "standard_charge_percentage": 40.0000, "estimated_amount": 7263, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 14527, "standard_charge_percentage": 80.0000, "estimated_amount": 14526, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 10895.2, "standard_charge_percentage": 60.0000, "estimated_amount": 10895, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 14527, "standard_charge_percentage": 80.0000, "estimated_amount": 14526, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 525.53, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1329.17, "estimated_amount": 1329, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.15, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 506.76, "estimated_amount": 506, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.15, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 525.53, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" }]}]} , { "description": "Hc Ntrapx C Ffr W/3D Funcjl Map", "code_information": [ { "code": "0523T", "type": "HCPCS" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 15937.4,"minimum": 4781.22,"maximum": 15937.4,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 14343.7, "standard_charge_percentage": 90.0000, "estimated_amount": 14343, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 12749.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12749, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 15140.5, "standard_charge_percentage": 95.0000, "estimated_amount": 15140, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 11156.2, "standard_charge_percentage": 70.0000, "estimated_amount": 11156, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 11156.2, "standard_charge_percentage": 70.0000, "estimated_amount": 11156, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 14343.7, "standard_charge_percentage": 90.0000, "estimated_amount": 14343, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 9562.44, "standard_charge_percentage": 60.0000, "estimated_amount": 9562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 7968.7, "standard_charge_percentage": 50.0000, "estimated_amount": 7968, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 11953, "standard_charge_percentage": 75.0000, "estimated_amount": 11953, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 12749.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12749.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 7968.7, "standard_charge_percentage": 50.0000, "estimated_amount": 7968, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 14343.7, "standard_charge_percentage": 90.0000, "estimated_amount": 14343, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 13546.8, "standard_charge_percentage": 85.0000, "estimated_amount": 13546, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 13945.2, "standard_charge_percentage": 87.5000, "estimated_amount": 13945, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 12749.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12749, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 11953, "standard_charge_percentage": 75.0000, "estimated_amount": 11953, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 13068.7, "standard_charge_percentage": 82.0000, "estimated_amount": 13068, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8924.94, "standard_charge_percentage": 56.0000, "estimated_amount": 8924, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 14343.7, "standard_charge_percentage": 90.0000, "estimated_amount": 14343, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 12749.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 11953, "standard_charge_percentage": 75.0000, "estimated_amount": 11953, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 11156.2, "standard_charge_percentage": 70.0000, "estimated_amount": 11156, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 11953, "standard_charge_percentage": 75.0000, "estimated_amount": 11953, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6374.96, "standard_charge_percentage": 40.0000, "estimated_amount": 6374, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 13945.2, "standard_charge_percentage": 87.5000, "estimated_amount": 13945, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 12749.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12749, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 12749.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12749, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 15937.4, "standard_charge_percentage": 100.0000, "estimated_amount": 15937, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 15937.4, "standard_charge_percentage": 100.0000, "estimated_amount": 15937, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 9562.44, "standard_charge_percentage": 60.0000, "estimated_amount": 9562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12749.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12749, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 12749.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4781.22, "standard_charge_percentage": 30.0000, "estimated_amount": 4781, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9243.69, "standard_charge_percentage": 58.0000, "estimated_amount": 9243, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 5896.84, "standard_charge_percentage": 37.0000, "estimated_amount": 5896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12749.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12749, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 14343.7, "standard_charge_percentage": 90.0000, "estimated_amount": 14343, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 15618.7, "standard_charge_percentage": 98.0000, "estimated_amount": 15618, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 11953, "standard_charge_percentage": 75.0000, "estimated_amount": 11953, "methodology": "percent of total billed charges" }]}]} , { "description": "FNA BX US GUIDANCE 1ST LESION", "code_information": [ { "code": "10005", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3523.56, "discounted_cash": 860,"minimum": 376.57,"maximum": 3523.56,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 857.71, "estimated_amount": 857, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2818.85, "standard_charge_percentage": 80.0000, "estimated_amount": 2818, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1761.78, "standard_charge_percentage": 50.0000, "estimated_amount": 1761, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3171.2, "standard_charge_percentage": 90.0000, "estimated_amount": 3171, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2995.03, "standard_charge_percentage": 85.0000, "estimated_amount": 2995, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2114.14, "standard_charge_percentage": 60.0000, "estimated_amount": 2114, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2466.49, "standard_charge_percentage": 70.0000, "estimated_amount": 2466, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2642.67, "standard_charge_percentage": 75.0000, "estimated_amount": 2642, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2043.66, "standard_charge_percentage": 58.0000, "estimated_amount": 2043, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 893.54, "estimated_amount": 893, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1224.48, "estimated_amount": 1224, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 863.71, "estimated_amount": 863, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 376.57, "estimated_amount": 376, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 869.71, "estimated_amount": 869, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2818.85, "standard_charge_percentage": 80.0000, "estimated_amount": 2818, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3083.11, "standard_charge_percentage": 87.5000, "estimated_amount": 3083, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3083.11, "standard_charge_percentage": 87.5000, "estimated_amount": 3083, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2818.85, "standard_charge_percentage": 80.0000, "estimated_amount": 2818, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3523.56, "standard_charge_percentage": 100.0000, "estimated_amount": 3523, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2818.85, "standard_charge_percentage": 80.0000, "estimated_amount": 2818, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2818.85, "standard_charge_percentage": 80.0000, "estimated_amount": 2818, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2466.49, "standard_charge_percentage": 70.0000, "estimated_amount": 2466, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2466.49, "standard_charge_percentage": 70.0000, "estimated_amount": 2466, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2889.32, "standard_charge_percentage": 82.0000, "estimated_amount": 2889, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1973.19, "standard_charge_percentage": 56.0000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1303.72, "standard_charge_percentage": 37.0000, "estimated_amount": 1303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2818.85, "standard_charge_percentage": 80.0000, "estimated_amount": 2818, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3171.2, "standard_charge_percentage": 90.0000, "estimated_amount": 3171, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3453.09, "standard_charge_percentage": 98.0000, "estimated_amount": 3453, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2642.67, "standard_charge_percentage": 75.0000, "estimated_amount": 2642, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2343.63, "estimated_amount": 2343, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 675.12, "estimated_amount": 675, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 650.66, "estimated_amount": 650, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2642.67, "standard_charge_percentage": 75.0000, "estimated_amount": 2642, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2642.67, "standard_charge_percentage": 75.0000, "estimated_amount": 2642, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3171.2, "standard_charge_percentage": 90.0000, "estimated_amount": 3171, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2818.85, "standard_charge_percentage": 80.0000, "estimated_amount": 2818, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3523.56, "standard_charge_percentage": 100.0000, "estimated_amount": 3523, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3347.38, "standard_charge_percentage": 95.0000, "estimated_amount": 3347, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2818.85, "standard_charge_percentage": 80.0000, "estimated_amount": 2818, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2818.85, "standard_charge_percentage": 80.0000, "estimated_amount": 2818, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1057.07, "standard_charge_percentage": 30.0000, "estimated_amount": 1057, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2642.67, "standard_charge_percentage": 75.0000, "estimated_amount": 2642, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3171.2, "standard_charge_percentage": 90.0000, "estimated_amount": 3171, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 376.57, "estimated_amount": 376, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3171.2, "standard_charge_percentage": 90.0000, "estimated_amount": 3171, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1409.42, "standard_charge_percentage": 40.0000, "estimated_amount": 1409, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2818.85, "standard_charge_percentage": 80.0000, "estimated_amount": 2818, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2114.14, "standard_charge_percentage": 60.0000, "estimated_amount": 2114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1323.76, "estimated_amount": 1323, "methodology": "fee schedule" }]}]} , { "description": "FNA BX US GDN EA ADDL LESION", "code_information": [ { "code": "10006", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1804.81,"minimum": 541.44,"maximum": 1804.81,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1624.33, "standard_charge_percentage": 90.0000, "estimated_amount": 1624, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1443.85, "standard_charge_percentage": 80.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1443.85, "standard_charge_percentage": 80.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 541.44, "standard_charge_percentage": 30.0000, "estimated_amount": 541, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 667.78, "standard_charge_percentage": 37.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1624.33, "standard_charge_percentage": 90.0000, "estimated_amount": 1624, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1624.33, "standard_charge_percentage": 90.0000, "estimated_amount": 1624, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1579.21, "standard_charge_percentage": 87.5000, "estimated_amount": 1579, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1579.21, "standard_charge_percentage": 87.5000, "estimated_amount": 1579, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1714.57, "standard_charge_percentage": 95.0000, "estimated_amount": 1714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1443.85, "standard_charge_percentage": 80.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1443.85, "standard_charge_percentage": 80.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1353.61, "standard_charge_percentage": 75.0000, "estimated_amount": 1353, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1263.37, "standard_charge_percentage": 70.0000, "estimated_amount": 1263, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1479.94, "standard_charge_percentage": 82.0000, "estimated_amount": 1479, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1082.89, "standard_charge_percentage": 60.0000, "estimated_amount": 1082, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1353.61, "standard_charge_percentage": 75.0000, "estimated_amount": 1353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 902.4, "standard_charge_percentage": 50.0000, "estimated_amount": 902, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1443.85, "standard_charge_percentage": 80.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1804.81, "standard_charge_percentage": 100.0000, "estimated_amount": 1804, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1804.81, "standard_charge_percentage": 100.0000, "estimated_amount": 1804, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1082.89, "standard_charge_percentage": 60.0000, "estimated_amount": 1082, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1443.85, "standard_charge_percentage": 80.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1263.37, "standard_charge_percentage": 70.0000, "estimated_amount": 1263, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1010.69, "standard_charge_percentage": 56.0000, "estimated_amount": 1010, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1624.33, "standard_charge_percentage": 90.0000, "estimated_amount": 1624, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1768.71, "standard_charge_percentage": 98.0000, "estimated_amount": 1768, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1443.85, "standard_charge_percentage": 80.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1353.61, "standard_charge_percentage": 75.0000, "estimated_amount": 1353, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1443.85, "standard_charge_percentage": 80.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1534.09, "standard_charge_percentage": 85.0000, "estimated_amount": 1534, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 721.92, "standard_charge_percentage": 40.0000, "estimated_amount": 721, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1443.85, "standard_charge_percentage": 80.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1263.37, "standard_charge_percentage": 70.0000, "estimated_amount": 1263, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1353.61, "standard_charge_percentage": 75.0000, "estimated_amount": 1353, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1046.79, "standard_charge_percentage": 58.0000, "estimated_amount": 1046, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1443.85, "standard_charge_percentage": 80.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1624.33, "standard_charge_percentage": 90.0000, "estimated_amount": 1624, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1353.61, "standard_charge_percentage": 75.0000, "estimated_amount": 1353, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Fine Needle Aspiration Bx W/Fluor Gdn Ea Addl", "code_information": [ { "code": "10008", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 704.48,"minimum": 211.34,"maximum": 704.48,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 528.36, "standard_charge_percentage": 75.0000, "estimated_amount": 528, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 634.03, "standard_charge_percentage": 90.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 634.03, "standard_charge_percentage": 90.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 493.14, "standard_charge_percentage": 70.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 577.67, "standard_charge_percentage": 82.0000, "estimated_amount": 577, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 260.66, "standard_charge_percentage": 37.0000, "estimated_amount": 260, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 528.36, "standard_charge_percentage": 75.0000, "estimated_amount": 528, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 528.36, "standard_charge_percentage": 75.0000, "estimated_amount": 528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 352.24, "standard_charge_percentage": 50.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 422.69, "standard_charge_percentage": 60.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 493.14, "standard_charge_percentage": 70.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 394.51, "standard_charge_percentage": 56.0000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 634.03, "standard_charge_percentage": 90.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 634.03, "standard_charge_percentage": 90.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 616.42, "standard_charge_percentage": 87.5000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 704.48, "standard_charge_percentage": 100.0000, "estimated_amount": 704, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 493.14, "standard_charge_percentage": 70.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 528.36, "standard_charge_percentage": 75.0000, "estimated_amount": 528, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 408.6, "standard_charge_percentage": 58.0000, "estimated_amount": 408, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 690.39, "standard_charge_percentage": 98.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 704.48, "estimated_amount": 704, "methodology": "case rate" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 598.81, "standard_charge_percentage": 85.0000, "estimated_amount": 598, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 281.79, "standard_charge_percentage": 40.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 616.42, "standard_charge_percentage": 87.5000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 704.48, "standard_charge_percentage": 100.0000, "estimated_amount": 704, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 669.26, "standard_charge_percentage": 95.0000, "estimated_amount": 669, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 211.34, "standard_charge_percentage": 30.0000, "estimated_amount": 211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 528.36, "standard_charge_percentage": 75.0000, "estimated_amount": 528, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 634.03, "standard_charge_percentage": 90.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 422.69, "standard_charge_percentage": 60.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Incision & Drain Skin Abscess Simple", "code_information": [ { "code": "10060", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 931.67, "discounted_cash": 242,"minimum": 169.39,"maximum": 7371.71,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 372.67, "standard_charge_percentage": 40.0000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 931.67, "standard_charge_percentage": 100.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 521.74, "standard_charge_percentage": 56.0000, "estimated_amount": 521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 913.04, "standard_charge_percentage": 98.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2948.68, "standard_charge_percentage": 40.0000, "estimated_amount": 2948, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7003.12, "standard_charge_percentage": 95.0000, "estimated_amount": 7003, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4423.03, "standard_charge_percentage": 60.0000, "estimated_amount": 4423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6044.8, "standard_charge_percentage": 82.0000, "estimated_amount": 6044, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4128.16, "standard_charge_percentage": 56.0000, "estimated_amount": 4128, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4275.59, "standard_charge_percentage": 58.0000, "estimated_amount": 4275, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2727.53, "standard_charge_percentage": 37.0000, "estimated_amount": 2727, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4423.03, "standard_charge_percentage": 60.0000, "estimated_amount": 4423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 202.02, "estimated_amount": 202, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 791.92, "standard_charge_percentage": 85.0000, "estimated_amount": 791, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 815.21, "standard_charge_percentage": 87.5000, "estimated_amount": 815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 931.67, "standard_charge_percentage": 100.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 559, "standard_charge_percentage": 60.0000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 279.5, "standard_charge_percentage": 30.0000, "estimated_amount": 279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 931.67, "estimated_amount": 931, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 885.09, "standard_charge_percentage": 95.0000, "estimated_amount": 885, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 763.97, "standard_charge_percentage": 82.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 559, "standard_charge_percentage": 60.0000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 202.02, "estimated_amount": 202, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6450.25, "standard_charge_percentage": 87.5000, "estimated_amount": 6450, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2211.51, "standard_charge_percentage": 30.0000, "estimated_amount": 2211, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7224.28, "standard_charge_percentage": 98.0000, "estimated_amount": 7224, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3685.86, "standard_charge_percentage": 50.0000, "estimated_amount": 3685, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7371.71, "standard_charge_percentage": 100.0000, "estimated_amount": 7371, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5160.2, "standard_charge_percentage": 70.0000, "estimated_amount": 5160, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 465.83, "standard_charge_percentage": 50.0000, "estimated_amount": 465, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 815.21, "standard_charge_percentage": 87.5000, "estimated_amount": 815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 540.37, "standard_charge_percentage": 58.0000, "estimated_amount": 540, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 344.72, "standard_charge_percentage": 37.0000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6265.95, "standard_charge_percentage": 85.0000, "estimated_amount": 6265, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6450.25, "standard_charge_percentage": 87.5000, "estimated_amount": 6450, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7371.71, "standard_charge_percentage": 100.0000, "estimated_amount": 7371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5160.2, "standard_charge_percentage": 70.0000, "estimated_amount": 5160, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5160.2, "standard_charge_percentage": 70.0000, "estimated_amount": 5160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" }]}]} , { "description": "Hc Incision & Drain Skin Abscess Complic", "code_information": [ { "code": "10061", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 222.22,"maximum": 1928.66,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 222.22, "estimated_amount": 222, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" }]}]} , { "description": "Hc Incision & Drain Pilonidal Cyst Simpl", "code_information": [ { "code": "10080", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3472.36, "discounted_cash": 860,"minimum": 227.92,"maximum": 3472.36,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2604.27, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1736.18, "standard_charge_percentage": 50.0000, "estimated_amount": 1736, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3472.36, "standard_charge_percentage": 100.0000, "estimated_amount": 3472, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3298.74, "standard_charge_percentage": 95.0000, "estimated_amount": 3298, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1041.71, "standard_charge_percentage": 30.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2430.65, "standard_charge_percentage": 70.0000, "estimated_amount": 2430, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1944.52, "standard_charge_percentage": 56.0000, "estimated_amount": 1944, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3402.91, "standard_charge_percentage": 98.0000, "estimated_amount": 3402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2083.42, "standard_charge_percentage": 60.0000, "estimated_amount": 2083, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2343.63, "estimated_amount": 2343, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 863.71, "estimated_amount": 863, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3125.12, "standard_charge_percentage": 90.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3038.32, "standard_charge_percentage": 87.5000, "estimated_amount": 3038, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3038.32, "standard_charge_percentage": 87.5000, "estimated_amount": 3038, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2430.65, "standard_charge_percentage": 70.0000, "estimated_amount": 2430, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3125.12, "standard_charge_percentage": 90.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 893.54, "estimated_amount": 893, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 227.92, "estimated_amount": 227, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 869.71, "estimated_amount": 869, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3125.12, "standard_charge_percentage": 90.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2430.65, "standard_charge_percentage": 70.0000, "estimated_amount": 2430, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2847.34, "standard_charge_percentage": 82.0000, "estimated_amount": 2847, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1284.77, "standard_charge_percentage": 37.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1224.48, "estimated_amount": 1224, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 650.66, "estimated_amount": 650, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 857.71, "estimated_amount": 857, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2604.27, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3125.12, "standard_charge_percentage": 90.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2951.51, "standard_charge_percentage": 85.0000, "estimated_amount": 2951, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1388.94, "standard_charge_percentage": 40.0000, "estimated_amount": 1388, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3472.36, "standard_charge_percentage": 100.0000, "estimated_amount": 3472, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2083.42, "standard_charge_percentage": 60.0000, "estimated_amount": 2083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2604.27, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2604.27, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2013.97, "standard_charge_percentage": 58.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3125.12, "standard_charge_percentage": 90.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2604.27, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 675.12, "estimated_amount": 675, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1323.76, "estimated_amount": 1323, "methodology": "fee schedule" }]}]} , { "description": "EXC SHOULDER LES SUBQ 3CM/>", "code_information": [ { "code": "10120", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 223.08,"maximum": 1928.66,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 223.08, "estimated_amount": 223, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" }]}]} , { "description": "I&R FOREIGN BDY SUBQ TISS SMPL", "code_information": [ { "code": "10140", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7520.97, "discounted_cash": 1981,"minimum": 525.22,"maximum": 7520.97,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6392.82, "standard_charge_percentage": 85.0000, "estimated_amount": 6392, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3008.39, "standard_charge_percentage": 40.0000, "estimated_amount": 3008, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7520.97, "standard_charge_percentage": 100.0000, "estimated_amount": 7520, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7144.92, "standard_charge_percentage": 95.0000, "estimated_amount": 7144, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7520.97, "standard_charge_percentage": 100.0000, "estimated_amount": 7520, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4211.74, "standard_charge_percentage": 56.0000, "estimated_amount": 4211, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2782.76, "standard_charge_percentage": 37.0000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7370.55, "standard_charge_percentage": 98.0000, "estimated_amount": 7370, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4512.58, "standard_charge_percentage": 60.0000, "estimated_amount": 4512, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2256.29, "standard_charge_percentage": 30.0000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6580.85, "standard_charge_percentage": 87.5000, "estimated_amount": 6580, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4362.16, "standard_charge_percentage": 58.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4512.58, "standard_charge_percentage": 60.0000, "estimated_amount": 4512, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3760.49, "standard_charge_percentage": 50.0000, "estimated_amount": 3760, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6580.85, "standard_charge_percentage": 87.5000, "estimated_amount": 6580, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6167.2, "standard_charge_percentage": 82.0000, "estimated_amount": 6167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" }]}]} , { "description": "EXC BEN LES SC/NK/H/F0.6-1.0CM", "code_information": [ { "code": "10160", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 223.08,"maximum": 1928.66,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 223.08, "estimated_amount": 223, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" }]}]} , { "description": "Hc Complex Drainage, Wound", "code_information": [ { "code": "10180", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 13942.9, "discounted_cash": 3500,"minimum": 898,"maximum": 13942.9,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 10457.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10457, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 12548.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12548, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 11851.5, "standard_charge_percentage": 85.0000, "estimated_amount": 11851, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 10457.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 13664, "standard_charge_percentage": 98.0000, "estimated_amount": 13664, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9533.36, "estimated_amount": 9533, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2746.23, "estimated_amount": 2746, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3513.37, "estimated_amount": 3513, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 920.5, "estimated_amount": 920, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3537.77, "estimated_amount": 3537, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6971.45, "standard_charge_percentage": 50.0000, "estimated_amount": 6971, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5577.16, "standard_charge_percentage": 40.0000, "estimated_amount": 5577, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 13942.9, "standard_charge_percentage": 100.0000, "estimated_amount": 13942, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 13245.8, "standard_charge_percentage": 95.0000, "estimated_amount": 13245, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 13942.9, "standard_charge_percentage": 100.0000, "estimated_amount": 13942, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 8365.74, "standard_charge_percentage": 60.0000, "estimated_amount": 8365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 9760.03, "standard_charge_percentage": 70.0000, "estimated_amount": 9760, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 9760.03, "standard_charge_percentage": 70.0000, "estimated_amount": 9760, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 11433.2, "standard_charge_percentage": 82.0000, "estimated_amount": 11433, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 8086.88, "standard_charge_percentage": 58.0000, "estimated_amount": 8086, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 12548.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12548, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 8365.74, "standard_charge_percentage": 60.0000, "estimated_amount": 8365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3634.71, "estimated_amount": 3634, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4980.9, "estimated_amount": 4980, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3488.97, "estimated_amount": 3488, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 10457.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10457, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 12548.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12548, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 12548.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12548, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 10457.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10457, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5384.76, "estimated_amount": 5384, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2589.97, "estimated_amount": 2589, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 12548.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12548, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 12200, "standard_charge_percentage": 87.5000, "estimated_amount": 12200, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 12200, "standard_charge_percentage": 87.5000, "estimated_amount": 12200, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4182.87, "standard_charge_percentage": 30.0000, "estimated_amount": 4182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 10457.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10457, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 9760.03, "standard_charge_percentage": 70.0000, "estimated_amount": 9760, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 7808.02, "standard_charge_percentage": 56.0000, "estimated_amount": 7808, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" }]}]} , { "description": "RMVL TUNNELED CV CATH WO PORT", "code_information": [ { "code": "11042", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1824.32, "discounted_cash": 488,"minimum": 286,"maximum": 1824.32,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1459.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1641.89, "standard_charge_percentage": 90.0000, "estimated_amount": 1641, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1641.89, "standard_charge_percentage": 90.0000, "estimated_amount": 1641, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1550.67, "standard_charge_percentage": 85.0000, "estimated_amount": 1550, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1459.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1459.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1641.89, "standard_charge_percentage": 90.0000, "estimated_amount": 1641, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1596.28, "standard_charge_percentage": 87.5000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1824.32, "standard_charge_percentage": 100.0000, "estimated_amount": 1824, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1094.59, "standard_charge_percentage": 60.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1459.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 547.3, "standard_charge_percentage": 30.0000, "estimated_amount": 547, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1277.02, "standard_charge_percentage": 70.0000, "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1277.02, "standard_charge_percentage": 70.0000, "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1277.02, "standard_charge_percentage": 70.0000, "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1368.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1368, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1021.62, "standard_charge_percentage": 56.0000, "estimated_amount": 1021, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1058.11, "standard_charge_percentage": 58.0000, "estimated_amount": 1058, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1787.83, "standard_charge_percentage": 98.0000, "estimated_amount": 1787, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1824.32, "estimated_amount": 1824, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1459.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 912.16, "standard_charge_percentage": 50.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 729.73, "standard_charge_percentage": 40.0000, "estimated_amount": 729, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1596.28, "standard_charge_percentage": 87.5000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1459.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1459.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1733.1, "standard_charge_percentage": 95.0000, "estimated_amount": 1733, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1824.32, "standard_charge_percentage": 100.0000, "estimated_amount": 1824, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1459.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1368.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1368, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1641.89, "standard_charge_percentage": 90.0000, "estimated_amount": 1641, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1641.89, "standard_charge_percentage": 90.0000, "estimated_amount": 1641, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1368.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1368, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1094.59, "standard_charge_percentage": 60.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1368.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1368, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1368.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1368, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1459.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1495.94, "standard_charge_percentage": 82.0000, "estimated_amount": 1495, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 675, "standard_charge_percentage": 37.0000, "estimated_amount": 675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1459.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" }]}]} , { "description": "I&D ABSCESS DEEP LEG/ANKLE", "code_information": [ { "code": "11043", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2755.96, "discounted_cash": 748,"minimum": 228.8,"maximum": 2755.96,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 756.65, "estimated_amount": 756, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1377.98, "standard_charge_percentage": 50.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2480.36, "standard_charge_percentage": 90.0000, "estimated_amount": 2480, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2411.47, "standard_charge_percentage": 87.5000, "estimated_amount": 2411, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2618.16, "standard_charge_percentage": 95.0000, "estimated_amount": 2618, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2204.77, "standard_charge_percentage": 80.0000, "estimated_amount": 2204, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2204.77, "standard_charge_percentage": 80.0000, "estimated_amount": 2204, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2204.77, "standard_charge_percentage": 80.0000, "estimated_amount": 2204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 826.79, "standard_charge_percentage": 30.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1929.17, "standard_charge_percentage": 70.0000, "estimated_amount": 1929, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1543.34, "standard_charge_percentage": 56.0000, "estimated_amount": 1543, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1598.46, "standard_charge_percentage": 58.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1019.71, "standard_charge_percentage": 37.0000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1653.58, "standard_charge_percentage": 60.0000, "estimated_amount": 1653, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2038.97, "estimated_amount": 2038, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 228.8, "estimated_amount": 228, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 746.22, "estimated_amount": 746, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2204.77, "standard_charge_percentage": 80.0000, "estimated_amount": 2204, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2204.77, "standard_charge_percentage": 80.0000, "estimated_amount": 2204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2204.77, "standard_charge_percentage": 80.0000, "estimated_amount": 2204, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1929.17, "standard_charge_percentage": 70.0000, "estimated_amount": 1929, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1929.17, "standard_charge_percentage": 70.0000, "estimated_amount": 1929, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2480.36, "standard_charge_percentage": 90.0000, "estimated_amount": 2480, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2066.97, "standard_charge_percentage": 75.0000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 587.36, "estimated_amount": 587, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 777.38, "estimated_amount": 777, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1151.68, "estimated_amount": 1151, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2066.97, "standard_charge_percentage": 75.0000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2066.97, "standard_charge_percentage": 75.0000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2204.77, "standard_charge_percentage": 80.0000, "estimated_amount": 2204, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2342.57, "standard_charge_percentage": 85.0000, "estimated_amount": 2342, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2204.77, "standard_charge_percentage": 80.0000, "estimated_amount": 2204, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2755.96, "standard_charge_percentage": 100.0000, "estimated_amount": 2755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2066.97, "standard_charge_percentage": 75.0000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2066.97, "standard_charge_percentage": 75.0000, "estimated_amount": 2066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1065.3, "estimated_amount": 1065, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 751.44, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 582.46, "estimated_amount": 582, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2480.36, "standard_charge_percentage": 90.0000, "estimated_amount": 2480, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2480.36, "standard_charge_percentage": 90.0000, "estimated_amount": 2480, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1102.38, "standard_charge_percentage": 40.0000, "estimated_amount": 1102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2411.47, "standard_charge_percentage": 87.5000, "estimated_amount": 2411, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2204.77, "standard_charge_percentage": 80.0000, "estimated_amount": 2204, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2755.96, "standard_charge_percentage": 100.0000, "estimated_amount": 2755, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1653.58, "standard_charge_percentage": 60.0000, "estimated_amount": 1653, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2259.89, "standard_charge_percentage": 82.0000, "estimated_amount": 2259, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2204.77, "standard_charge_percentage": 80.0000, "estimated_amount": 2204, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2480.36, "standard_charge_percentage": 90.0000, "estimated_amount": 2480, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2700.84, "standard_charge_percentage": 98.0000, "estimated_amount": 2700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" }]}]} , { "description": "INS PICC LINE WO IMG GUID 5YR+", "code_information": [ { "code": "11044", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7520.97, "discounted_cash": 1981,"minimum": 525.22,"maximum": 7520.97,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6392.82, "standard_charge_percentage": 85.0000, "estimated_amount": 6392, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3008.39, "standard_charge_percentage": 40.0000, "estimated_amount": 3008, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7370.55, "standard_charge_percentage": 98.0000, "estimated_amount": 7370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4512.58, "standard_charge_percentage": 60.0000, "estimated_amount": 4512, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3760.49, "standard_charge_percentage": 50.0000, "estimated_amount": 3760, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6580.85, "standard_charge_percentage": 87.5000, "estimated_amount": 6580, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6580.85, "standard_charge_percentage": 87.5000, "estimated_amount": 6580, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4362.16, "standard_charge_percentage": 58.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7520.97, "standard_charge_percentage": 100.0000, "estimated_amount": 7520, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4512.58, "standard_charge_percentage": 60.0000, "estimated_amount": 4512, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2256.29, "standard_charge_percentage": 30.0000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2782.76, "standard_charge_percentage": 37.0000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7520.97, "standard_charge_percentage": 100.0000, "estimated_amount": 7520, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7144.92, "standard_charge_percentage": 95.0000, "estimated_amount": 7144, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6167.2, "standard_charge_percentage": 82.0000, "estimated_amount": 6167, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4211.74, "standard_charge_percentage": 56.0000, "estimated_amount": 4211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" }]}]} , { "description": "DECLOT PORT W/ THROMB AGNT", "code_information": [ { "code": "11045", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1131.3,"minimum": 101.11,"maximum": 1131.3,"payers_information":[{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 905.04, "standard_charge_percentage": 80.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 905.04, "standard_charge_percentage": 80.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 848.48, "standard_charge_percentage": 75.0000, "estimated_amount": 848, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 791.91, "standard_charge_percentage": 70.0000, "estimated_amount": 791, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 791.91, "standard_charge_percentage": 70.0000, "estimated_amount": 791, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 848.48, "standard_charge_percentage": 75.0000, "estimated_amount": 848, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 656.15, "standard_charge_percentage": 58.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 848.48, "standard_charge_percentage": 75.0000, "estimated_amount": 848, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 452.52, "standard_charge_percentage": 40.0000, "estimated_amount": 452, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 905.04, "standard_charge_percentage": 80.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 678.78, "standard_charge_percentage": 60.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 339.39, "standard_charge_percentage": 30.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 927.67, "standard_charge_percentage": 82.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1108.67, "standard_charge_percentage": 98.0000, "estimated_amount": 1108, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 848.48, "standard_charge_percentage": 75.0000, "estimated_amount": 848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1131.3, "estimated_amount": 1131, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 905.04, "standard_charge_percentage": 80.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 905.04, "standard_charge_percentage": 80.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1018.17, "standard_charge_percentage": 90.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 989.89, "standard_charge_percentage": 87.5000, "estimated_amount": 989, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 905.04, "standard_charge_percentage": 80.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1074.73, "standard_charge_percentage": 95.0000, "estimated_amount": 1074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 905.04, "standard_charge_percentage": 80.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 791.91, "standard_charge_percentage": 70.0000, "estimated_amount": 791, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 418.58, "standard_charge_percentage": 37.0000, "estimated_amount": 418, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 905.04, "standard_charge_percentage": 80.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1018.17, "standard_charge_percentage": 90.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1018.17, "standard_charge_percentage": 90.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 101.11, "estimated_amount": 101, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 848.48, "standard_charge_percentage": 75.0000, "estimated_amount": 848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 565.65, "standard_charge_percentage": 50.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1018.17, "standard_charge_percentage": 90.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1018.17, "standard_charge_percentage": 90.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 961.61, "standard_charge_percentage": 85.0000, "estimated_amount": 961, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 989.89, "standard_charge_percentage": 87.5000, "estimated_amount": 989, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 905.04, "standard_charge_percentage": 80.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1131.3, "standard_charge_percentage": 100.0000, "estimated_amount": 1131, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1131.3, "standard_charge_percentage": 100.0000, "estimated_amount": 1131, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 905.04, "standard_charge_percentage": 80.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 633.53, "standard_charge_percentage": 56.0000, "estimated_amount": 633, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 678.78, "standard_charge_percentage": 60.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" }]}]} , { "description": "RPLC TUNNELED CV CATH W/PORT", "code_information": [ { "code": "11046", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1279.31,"minimum": 101.11,"maximum": 1279.31,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 959.48, "standard_charge_percentage": 75.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1023.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1023, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1087.41, "standard_charge_percentage": 85.0000, "estimated_amount": 1087, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 511.72, "standard_charge_percentage": 40.0000, "estimated_amount": 511, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1119.4, "standard_charge_percentage": 87.5000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1023.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1023, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1279.31, "standard_charge_percentage": 100.0000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1023.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1023, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1023.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 959.48, "standard_charge_percentage": 75.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 895.52, "standard_charge_percentage": 70.0000, "estimated_amount": 895, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 473.34, "standard_charge_percentage": 37.0000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 101.11, "estimated_amount": 101, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1151.38, "standard_charge_percentage": 90.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1119.4, "standard_charge_percentage": 87.5000, "estimated_amount": 1119, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1023.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1023, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1023.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 383.79, "standard_charge_percentage": 30.0000, "estimated_amount": 383, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 895.52, "standard_charge_percentage": 70.0000, "estimated_amount": 895, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 716.41, "standard_charge_percentage": 56.0000, "estimated_amount": 716, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1023.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1023, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1151.38, "standard_charge_percentage": 90.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1023.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1023, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1023.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1023, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 767.59, "standard_charge_percentage": 60.0000, "estimated_amount": 767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1279.31, "estimated_amount": 1279, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 959.48, "standard_charge_percentage": 75.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 639.65, "standard_charge_percentage": 50.0000, "estimated_amount": 639, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1151.38, "standard_charge_percentage": 90.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1151.38, "standard_charge_percentage": 90.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1279.31, "standard_charge_percentage": 100.0000, "estimated_amount": 1279, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1215.34, "standard_charge_percentage": 95.0000, "estimated_amount": 1215, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 767.59, "standard_charge_percentage": 60.0000, "estimated_amount": 767, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1023.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1023, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 895.52, "standard_charge_percentage": 70.0000, "estimated_amount": 895, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 959.48, "standard_charge_percentage": 75.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1049.03, "standard_charge_percentage": 82.0000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 742, "standard_charge_percentage": 58.0000, "estimated_amount": 742, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1151.38, "standard_charge_percentage": 90.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1253.72, "standard_charge_percentage": 98.0000, "estimated_amount": 1253, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 959.48, "standard_charge_percentage": 75.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" }]}]} , { "description": "COMPLETE RPL PICC WO PORT RS&I", "code_information": [ { "code": "11047", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2457.65,"minimum": 314.33,"maximum": 2457.65,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2211.89, "standard_charge_percentage": 90.0000, "estimated_amount": 2211, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2211.89, "standard_charge_percentage": 90.0000, "estimated_amount": 2211, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1966.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2457.65, "standard_charge_percentage": 100.0000, "estimated_amount": 2457, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1966.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1966.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 737.29, "standard_charge_percentage": 30.0000, "estimated_amount": 737, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1720.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1720, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2015.27, "standard_charge_percentage": 82.0000, "estimated_amount": 2015, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1376.28, "standard_charge_percentage": 56.0000, "estimated_amount": 1376, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2211.89, "standard_charge_percentage": 90.0000, "estimated_amount": 2211, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2408.5, "standard_charge_percentage": 98.0000, "estimated_amount": 2408, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1474.59, "standard_charge_percentage": 60.0000, "estimated_amount": 1474, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2211.89, "standard_charge_percentage": 90.0000, "estimated_amount": 2211, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1474.59, "standard_charge_percentage": 60.0000, "estimated_amount": 1474, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1966.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1966.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1720.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1720, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1966.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1843.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1843, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1966.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2089, "standard_charge_percentage": 85.0000, "estimated_amount": 2089, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1966.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2457.65, "standard_charge_percentage": 100.0000, "estimated_amount": 2457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1843.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 909.33, "standard_charge_percentage": 37.0000, "estimated_amount": 909, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2211.89, "standard_charge_percentage": 90.0000, "estimated_amount": 2211, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1843.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 314.33, "estimated_amount": 314, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1843.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1966.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1228.83, "standard_charge_percentage": 50.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 983.06, "standard_charge_percentage": 40.0000, "estimated_amount": 983, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2150.44, "standard_charge_percentage": 87.5000, "estimated_amount": 2150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2150.44, "standard_charge_percentage": 87.5000, "estimated_amount": 2150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1966.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1966, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2334.77, "standard_charge_percentage": 95.0000, "estimated_amount": 2334, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1720.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1720, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1843.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1425.44, "standard_charge_percentage": 58.0000, "estimated_amount": 1425, "methodology": "percent of total billed charges" }]}]} , { "description": "COMPLETE RPL PICC W/ PORT RS&I", "code_information": [ { "code": "11055", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 931.67, "discounted_cash": 242,"minimum": 169.39,"maximum": 931.67,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 465.83, "standard_charge_percentage": 50.0000, "estimated_amount": 465, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 885.09, "standard_charge_percentage": 95.0000, "estimated_amount": 885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 763.97, "standard_charge_percentage": 82.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 559, "standard_charge_percentage": 60.0000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 791.92, "standard_charge_percentage": 85.0000, "estimated_amount": 791, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 815.21, "standard_charge_percentage": 87.5000, "estimated_amount": 815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 559, "standard_charge_percentage": 60.0000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 279.5, "standard_charge_percentage": 30.0000, "estimated_amount": 279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 540.37, "standard_charge_percentage": 58.0000, "estimated_amount": 540, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 344.72, "standard_charge_percentage": 37.0000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 931.67, "estimated_amount": 931, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 372.67, "standard_charge_percentage": 40.0000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 931.67, "standard_charge_percentage": 100.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 931.67, "standard_charge_percentage": 100.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 815.21, "standard_charge_percentage": 87.5000, "estimated_amount": 815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 521.74, "standard_charge_percentage": 56.0000, "estimated_amount": 521, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 913.04, "standard_charge_percentage": 98.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" }]}]} , { "description": "PLC TUBE NASOGAST FLUOR GUIDE", "code_information": [ { "code": "11056", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 957.89, "discounted_cash": 242,"minimum": 169.39,"maximum": 957.89,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 718.42, "standard_charge_percentage": 75.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 478.94, "standard_charge_percentage": 50.0000, "estimated_amount": 478, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 287.37, "standard_charge_percentage": 30.0000, "estimated_amount": 287, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 670.52, "standard_charge_percentage": 70.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 670.52, "standard_charge_percentage": 70.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 718.42, "standard_charge_percentage": 75.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 354.42, "standard_charge_percentage": 37.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 718.42, "standard_charge_percentage": 75.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 718.42, "standard_charge_percentage": 75.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 862.1, "standard_charge_percentage": 90.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 862.1, "standard_charge_percentage": 90.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 838.15, "standard_charge_percentage": 87.5000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 910, "standard_charge_percentage": 95.0000, "estimated_amount": 910, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 957.89, "standard_charge_percentage": 100.0000, "estimated_amount": 957, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 670.52, "standard_charge_percentage": 70.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 785.47, "standard_charge_percentage": 82.0000, "estimated_amount": 785, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 862.1, "standard_charge_percentage": 90.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 862.1, "standard_charge_percentage": 90.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 574.73, "standard_charge_percentage": 60.0000, "estimated_amount": 574, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 957.89, "estimated_amount": 957, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 862.1, "standard_charge_percentage": 90.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 814.21, "standard_charge_percentage": 85.0000, "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 718.42, "standard_charge_percentage": 75.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 555.58, "standard_charge_percentage": 58.0000, "estimated_amount": 555, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 938.73, "standard_charge_percentage": 98.0000, "estimated_amount": 938, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 383.16, "standard_charge_percentage": 40.0000, "estimated_amount": 383, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 838.15, "standard_charge_percentage": 87.5000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 957.89, "standard_charge_percentage": 100.0000, "estimated_amount": 957, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 574.73, "standard_charge_percentage": 60.0000, "estimated_amount": 574, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 536.42, "standard_charge_percentage": 56.0000, "estimated_amount": 536, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" }]}]} , { "description": "Hc Tangential Biopsy Skin Single Lesion", "code_information": [ { "code": "11102", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 953.01, "discounted_cash": 242,"minimum": 114.69,"maximum": 953.01,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 126.16, "estimated_amount": 126, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 714.76, "standard_charge_percentage": 75.0000, "estimated_amount": 714, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 714.76, "standard_charge_percentage": 75.0000, "estimated_amount": 714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 762.41, "standard_charge_percentage": 80.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 857.71, "standard_charge_percentage": 90.0000, "estimated_amount": 857, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 381.2, "standard_charge_percentage": 40.0000, "estimated_amount": 381, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 833.88, "standard_charge_percentage": 87.5000, "estimated_amount": 833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 953.01, "standard_charge_percentage": 100.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 762.41, "standard_charge_percentage": 80.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 762.41, "standard_charge_percentage": 80.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 285.9, "standard_charge_percentage": 30.0000, "estimated_amount": 285, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 781.47, "standard_charge_percentage": 82.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 552.75, "standard_charge_percentage": 58.0000, "estimated_amount": 552, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 933.95, "standard_charge_percentage": 98.0000, "estimated_amount": 933, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 571.81, "standard_charge_percentage": 60.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 114.69, "estimated_amount": 114, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 857.71, "standard_charge_percentage": 90.0000, "estimated_amount": 857, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 857.71, "standard_charge_percentage": 90.0000, "estimated_amount": 857, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 762.41, "standard_charge_percentage": 80.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 762.41, "standard_charge_percentage": 80.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 762.41, "standard_charge_percentage": 80.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 667.11, "standard_charge_percentage": 70.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 667.11, "standard_charge_percentage": 70.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 714.76, "standard_charge_percentage": 75.0000, "estimated_amount": 714, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 857.71, "standard_charge_percentage": 90.0000, "estimated_amount": 857, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 833.88, "standard_charge_percentage": 87.5000, "estimated_amount": 833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 905.36, "standard_charge_percentage": 95.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 714.76, "standard_charge_percentage": 75.0000, "estimated_amount": 714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 762.41, "standard_charge_percentage": 80.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 714.76, "standard_charge_percentage": 75.0000, "estimated_amount": 714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 953.01, "estimated_amount": 953, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 762.41, "standard_charge_percentage": 80.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 476.5, "standard_charge_percentage": 50.0000, "estimated_amount": 476, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 810.06, "standard_charge_percentage": 85.0000, "estimated_amount": 810, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 762.41, "standard_charge_percentage": 80.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 762.41, "standard_charge_percentage": 80.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 953.01, "standard_charge_percentage": 100.0000, "estimated_amount": 953, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 571.81, "standard_charge_percentage": 60.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 667.11, "standard_charge_percentage": 70.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 533.69, "standard_charge_percentage": 56.0000, "estimated_amount": 533, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 352.61, "standard_charge_percentage": 37.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 857.71, "standard_charge_percentage": 90.0000, "estimated_amount": 857, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" }]}]} , { "description": "Hc Punch Biopsy Skin Single Lesion", "code_information": [ { "code": "11104", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 172.11, "discounted_cash": 488,"minimum": 51.63,"maximum": 172.11,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 137.69, "standard_charge_percentage": 80.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 129.08, "standard_charge_percentage": 75.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 137.69, "standard_charge_percentage": 80.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 172.11, "standard_charge_percentage": 100.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 137.69, "standard_charge_percentage": 80.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 120.48, "standard_charge_percentage": 70.0000, "estimated_amount": 120, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 137.69, "standard_charge_percentage": 80.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 154.9, "standard_charge_percentage": 90.0000, "estimated_amount": 154, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 129.08, "standard_charge_percentage": 75.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 129.17, "estimated_amount": 129, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 86.06, "standard_charge_percentage": 50.0000, "estimated_amount": 86, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 154.9, "standard_charge_percentage": 90.0000, "estimated_amount": 154, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 68.84, "standard_charge_percentage": 40.0000, "estimated_amount": 68, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 150.6, "standard_charge_percentage": 87.5000, "estimated_amount": 150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 137.69, "standard_charge_percentage": 80.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 163.5, "standard_charge_percentage": 95.0000, "estimated_amount": 163, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 103.27, "standard_charge_percentage": 60.0000, "estimated_amount": 103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 129.08, "standard_charge_percentage": 75.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 99.82, "standard_charge_percentage": 58.0000, "estimated_amount": 99, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 129.08, "standard_charge_percentage": 75.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 137.69, "standard_charge_percentage": 80.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 154.9, "standard_charge_percentage": 90.0000, "estimated_amount": 154, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 150.6, "standard_charge_percentage": 87.5000, "estimated_amount": 150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 137.69, "standard_charge_percentage": 80.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 137.69, "standard_charge_percentage": 80.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 137.69, "standard_charge_percentage": 80.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 120.48, "standard_charge_percentage": 70.0000, "estimated_amount": 120, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 120.48, "standard_charge_percentage": 70.0000, "estimated_amount": 120, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 141.13, "standard_charge_percentage": 82.0000, "estimated_amount": 141, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 96.38, "standard_charge_percentage": 56.0000, "estimated_amount": 96, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 63.68, "standard_charge_percentage": 37.0000, "estimated_amount": 63, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 154.9, "standard_charge_percentage": 90.0000, "estimated_amount": 154, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 168.67, "standard_charge_percentage": 98.0000, "estimated_amount": 168, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 103.27, "standard_charge_percentage": 60.0000, "estimated_amount": 103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 114.69, "estimated_amount": 114, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 154.9, "standard_charge_percentage": 90.0000, "estimated_amount": 154, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 146.29, "standard_charge_percentage": 85.0000, "estimated_amount": 146, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 137.69, "standard_charge_percentage": 80.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 172.11, "standard_charge_percentage": 100.0000, "estimated_amount": 172, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 51.63, "standard_charge_percentage": 30.0000, "estimated_amount": 51, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 129.08, "standard_charge_percentage": 75.0000, "estimated_amount": 129, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 172.11, "estimated_amount": 172, "methodology": "fee schedule" }]}]} , { "description": "Hc Incisional Biopsy Skin Single Lesion", "code_information": [ { "code": "11106", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1528.29, "discounted_cash": 748,"minimum": 204.15,"maximum": 1528.29,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1222.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1337.25, "standard_charge_percentage": 87.5000, "estimated_amount": 1337, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 100.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 100.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 916.97, "standard_charge_percentage": 60.0000, "estimated_amount": 916, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1222.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 886.41, "standard_charge_percentage": 58.0000, "estimated_amount": 886, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 565.47, "standard_charge_percentage": 37.0000, "estimated_amount": 565, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1375.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1375, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1497.72, "standard_charge_percentage": 98.0000, "estimated_amount": 1497, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1146.22, "standard_charge_percentage": 75.0000, "estimated_amount": 1146, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1151.68, "estimated_amount": 1151, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 204.15, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 582.46, "estimated_amount": 582, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 224.57, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 756.65, "estimated_amount": 756, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1146.22, "standard_charge_percentage": 75.0000, "estimated_amount": 1146, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1146.22, "standard_charge_percentage": 75.0000, "estimated_amount": 1146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 764.14, "standard_charge_percentage": 50.0000, "estimated_amount": 764, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1375.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1375, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1222.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1222.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1253.2, "standard_charge_percentage": 82.0000, "estimated_amount": 1253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1222.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 777.38, "estimated_amount": 777, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 746.22, "estimated_amount": 746, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1375.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1375, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1299.05, "standard_charge_percentage": 85.0000, "estimated_amount": 1299, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1222.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1146.22, "standard_charge_percentage": 75.0000, "estimated_amount": 1146, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1069.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1069.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1146.22, "standard_charge_percentage": 75.0000, "estimated_amount": 1146, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 855.84, "standard_charge_percentage": 56.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 916.97, "standard_charge_percentage": 60.0000, "estimated_amount": 916, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1528.29, "estimated_amount": 1528, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 587.36, "estimated_amount": 587, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1065.3, "estimated_amount": 1065, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 751.44, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1528.29, "estimated_amount": 1528, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1222.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1375.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1375, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 611.32, "standard_charge_percentage": 40.0000, "estimated_amount": 611, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1337.25, "standard_charge_percentage": 87.5000, "estimated_amount": 1337, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1222.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1222.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1451.88, "standard_charge_percentage": 95.0000, "estimated_amount": 1451, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1222.63, "standard_charge_percentage": 80.0000, "estimated_amount": 1222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 458.49, "standard_charge_percentage": 30.0000, "estimated_amount": 458, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1069.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1375.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1375, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" }]}]} , { "description": "Exc tr-ext b9+marg 2.1-3cm", "code_information": [ { "code": "11403", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8799.1, "discounted_cash": 860,"minimum": 257.4,"maximum": 8799.1,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 863.71, "estimated_amount": 863, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 857.71, "estimated_amount": 857, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8359.15, "standard_charge_percentage": 95.0000, "estimated_amount": 8359, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6159.37, "standard_charge_percentage": 70.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 60.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2343.63, "estimated_amount": 2343, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 893.54, "estimated_amount": 893, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 650.66, "estimated_amount": 650, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7479.23, "standard_charge_percentage": 85.0000, "estimated_amount": 7479, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7699.21, "standard_charge_percentage": 87.5000, "estimated_amount": 7699, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8799.1, "standard_charge_percentage": 100.0000, "estimated_amount": 8799, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6159.37, "standard_charge_percentage": 70.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 675.12, "estimated_amount": 675, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 869.71, "estimated_amount": 869, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7699.21, "standard_charge_percentage": 87.5000, "estimated_amount": 7699, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6159.37, "standard_charge_percentage": 70.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4927.5, "standard_charge_percentage": 56.0000, "estimated_amount": 4927, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3255.67, "standard_charge_percentage": 37.0000, "estimated_amount": 3255, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1323.76, "estimated_amount": 1323, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 257.4, "estimated_amount": 257, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4399.55, "standard_charge_percentage": 50.0000, "estimated_amount": 4399, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3519.64, "standard_charge_percentage": 40.0000, "estimated_amount": 3519, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8799.1, "standard_charge_percentage": 100.0000, "estimated_amount": 8799, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 60.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2639.73, "standard_charge_percentage": 30.0000, "estimated_amount": 2639, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7215.26, "standard_charge_percentage": 82.0000, "estimated_amount": 7215, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5103.48, "standard_charge_percentage": 58.0000, "estimated_amount": 5103, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8623.12, "standard_charge_percentage": 98.0000, "estimated_amount": 8623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1224.48, "estimated_amount": 1224, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11406", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5866.07, "discounted_cash": 1981,"minimum": 525.22,"maximum": 5866.07,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2933.03, "standard_charge_percentage": 50.0000, "estimated_amount": 2933, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 90.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4986.16, "standard_charge_percentage": 85.0000, "estimated_amount": 4986, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2346.43, "standard_charge_percentage": 40.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5132.81, "standard_charge_percentage": 87.5000, "estimated_amount": 5132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4692.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4399.55, "standard_charge_percentage": 75.0000, "estimated_amount": 4399, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3285, "standard_charge_percentage": 56.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3402.32, "standard_charge_percentage": 58.0000, "estimated_amount": 3402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4692.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4692, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5572.77, "standard_charge_percentage": 95.0000, "estimated_amount": 5572, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5866.07, "standard_charge_percentage": 100.0000, "estimated_amount": 5866, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3519.64, "standard_charge_percentage": 60.0000, "estimated_amount": 3519, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4692.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4692, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 90.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 90.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4399.55, "standard_charge_percentage": 75.0000, "estimated_amount": 4399, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3519.64, "standard_charge_percentage": 60.0000, "estimated_amount": 3519, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4692.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4692, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 90.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5132.81, "standard_charge_percentage": 87.5000, "estimated_amount": 5132, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4692.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4692, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5866.07, "standard_charge_percentage": 100.0000, "estimated_amount": 5866, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4692.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4692, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4106.25, "standard_charge_percentage": 70.0000, "estimated_amount": 4106, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4106.25, "standard_charge_percentage": 70.0000, "estimated_amount": 4106, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4692.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4692, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5748.75, "standard_charge_percentage": 98.0000, "estimated_amount": 5748, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4399.55, "standard_charge_percentage": 75.0000, "estimated_amount": 4399, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4399.55, "standard_charge_percentage": 75.0000, "estimated_amount": 4399, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4692.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4692, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 90.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4692.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4692, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4692.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1759.82, "standard_charge_percentage": 30.0000, "estimated_amount": 1759, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4106.25, "standard_charge_percentage": 70.0000, "estimated_amount": 4106, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4399.55, "standard_charge_percentage": 75.0000, "estimated_amount": 4399, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4810.18, "standard_charge_percentage": 82.0000, "estimated_amount": 4810, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11420", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6042.05, "discounted_cash": 1981,"minimum": 525.22,"maximum": 6042.05,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4833.64, "standard_charge_percentage": 80.0000, "estimated_amount": 4833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4833.64, "standard_charge_percentage": 80.0000, "estimated_amount": 4833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3021.03, "standard_charge_percentage": 50.0000, "estimated_amount": 3021, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5437.85, "standard_charge_percentage": 90.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4833.64, "standard_charge_percentage": 80.0000, "estimated_amount": 4833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4833.64, "standard_charge_percentage": 80.0000, "estimated_amount": 4833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 6042.05, "standard_charge_percentage": 100.0000, "estimated_amount": 6042, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5739.95, "standard_charge_percentage": 95.0000, "estimated_amount": 5739, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4833.64, "standard_charge_percentage": 80.0000, "estimated_amount": 4833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1812.62, "standard_charge_percentage": 30.0000, "estimated_amount": 1812, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4229.44, "standard_charge_percentage": 70.0000, "estimated_amount": 4229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4833.64, "standard_charge_percentage": 80.0000, "estimated_amount": 4833, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4531.54, "standard_charge_percentage": 75.0000, "estimated_amount": 4531, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4531.54, "standard_charge_percentage": 75.0000, "estimated_amount": 4531, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5437.85, "standard_charge_percentage": 90.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2416.82, "standard_charge_percentage": 40.0000, "estimated_amount": 2416, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4833.64, "standard_charge_percentage": 80.0000, "estimated_amount": 4833, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4229.44, "standard_charge_percentage": 70.0000, "estimated_amount": 4229, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4229.44, "standard_charge_percentage": 70.0000, "estimated_amount": 4229, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5437.85, "standard_charge_percentage": 90.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5135.74, "standard_charge_percentage": 85.0000, "estimated_amount": 5135, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5286.79, "standard_charge_percentage": 87.5000, "estimated_amount": 5286, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4833.64, "standard_charge_percentage": 80.0000, "estimated_amount": 4833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 6042.05, "standard_charge_percentage": 100.0000, "estimated_amount": 6042, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3625.23, "standard_charge_percentage": 60.0000, "estimated_amount": 3625, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4833.64, "standard_charge_percentage": 80.0000, "estimated_amount": 4833, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4531.54, "standard_charge_percentage": 75.0000, "estimated_amount": 4531, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3383.55, "standard_charge_percentage": 56.0000, "estimated_amount": 3383, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5437.85, "standard_charge_percentage": 90.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3625.23, "standard_charge_percentage": 60.0000, "estimated_amount": 3625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5437.85, "standard_charge_percentage": 90.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5286.79, "standard_charge_percentage": 87.5000, "estimated_amount": 5286, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4833.64, "standard_charge_percentage": 80.0000, "estimated_amount": 4833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4531.54, "standard_charge_percentage": 75.0000, "estimated_amount": 4531, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4954.48, "standard_charge_percentage": 82.0000, "estimated_amount": 4954, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3504.39, "standard_charge_percentage": 58.0000, "estimated_amount": 3504, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2235.56, "standard_charge_percentage": 37.0000, "estimated_amount": 2235, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5921.21, "standard_charge_percentage": 98.0000, "estimated_amount": 5921, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4531.54, "standard_charge_percentage": 75.0000, "estimated_amount": 4531, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" }]}]} , { "description": "Exc h-f-nk-sp b9+marg 2.1-3", "code_information": [ { "code": "11423", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9010.44, "discounted_cash": 1981,"minimum": 525.22,"maximum": 9010.44,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6757.83, "standard_charge_percentage": 75.0000, "estimated_amount": 6757, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7208.35, "standard_charge_percentage": 80.0000, "estimated_amount": 7208, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7208.35, "standard_charge_percentage": 80.0000, "estimated_amount": 7208, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5406.26, "standard_charge_percentage": 60.0000, "estimated_amount": 5406, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6307.31, "standard_charge_percentage": 70.0000, "estimated_amount": 6307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7208.35, "standard_charge_percentage": 80.0000, "estimated_amount": 7208, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8109.4, "standard_charge_percentage": 90.0000, "estimated_amount": 8109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7208.35, "standard_charge_percentage": 80.0000, "estimated_amount": 7208, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8109.4, "standard_charge_percentage": 90.0000, "estimated_amount": 8109, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8109.4, "standard_charge_percentage": 90.0000, "estimated_amount": 8109, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7884.14, "standard_charge_percentage": 87.5000, "estimated_amount": 7884, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7884.14, "standard_charge_percentage": 87.5000, "estimated_amount": 7884, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7208.35, "standard_charge_percentage": 80.0000, "estimated_amount": 7208, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2703.13, "standard_charge_percentage": 30.0000, "estimated_amount": 2703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6757.83, "standard_charge_percentage": 75.0000, "estimated_amount": 6757, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6307.31, "standard_charge_percentage": 70.0000, "estimated_amount": 6307, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6307.31, "standard_charge_percentage": 70.0000, "estimated_amount": 6307, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7388.56, "standard_charge_percentage": 82.0000, "estimated_amount": 7388, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3333.86, "standard_charge_percentage": 37.0000, "estimated_amount": 3333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5406.26, "standard_charge_percentage": 60.0000, "estimated_amount": 5406, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4505.22, "standard_charge_percentage": 50.0000, "estimated_amount": 4505, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8109.4, "standard_charge_percentage": 90.0000, "estimated_amount": 8109, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3604.18, "standard_charge_percentage": 40.0000, "estimated_amount": 3604, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7208.35, "standard_charge_percentage": 80.0000, "estimated_amount": 7208, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9010.44, "standard_charge_percentage": 100.0000, "estimated_amount": 9010, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8559.92, "standard_charge_percentage": 95.0000, "estimated_amount": 8559, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9010.44, "standard_charge_percentage": 100.0000, "estimated_amount": 9010, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7208.35, "standard_charge_percentage": 80.0000, "estimated_amount": 7208, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5045.85, "standard_charge_percentage": 56.0000, "estimated_amount": 5045, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8109.4, "standard_charge_percentage": 90.0000, "estimated_amount": 8109, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6757.83, "standard_charge_percentage": 75.0000, "estimated_amount": 6757, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7658.87, "standard_charge_percentage": 85.0000, "estimated_amount": 7658, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7208.35, "standard_charge_percentage": 80.0000, "estimated_amount": 7208, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7208.35, "standard_charge_percentage": 80.0000, "estimated_amount": 7208, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7208.35, "standard_charge_percentage": 80.0000, "estimated_amount": 7208, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6757.83, "standard_charge_percentage": 75.0000, "estimated_amount": 6757, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5226.06, "standard_charge_percentage": 58.0000, "estimated_amount": 5226, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8830.23, "standard_charge_percentage": 98.0000, "estimated_amount": 8830, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6757.83, "standard_charge_percentage": 75.0000, "estimated_amount": 6757, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "11424", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 11297.7, "discounted_cash": 1981,"minimum": 525.22,"maximum": 11297.7,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 9038.16, "standard_charge_percentage": 80.0000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 10167.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10167, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 9885.49, "standard_charge_percentage": 87.5000, "estimated_amount": 9885, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 11297.7, "standard_charge_percentage": 100.0000, "estimated_amount": 11297, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 6552.67, "standard_charge_percentage": 58.0000, "estimated_amount": 6552, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 8473.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8473, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 10167.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10167, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 9885.49, "standard_charge_percentage": 87.5000, "estimated_amount": 9885, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 9038.16, "standard_charge_percentage": 80.0000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 9038.16, "standard_charge_percentage": 80.0000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 9038.16, "standard_charge_percentage": 80.0000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 11297.7, "standard_charge_percentage": 100.0000, "estimated_amount": 11297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 8473.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8473, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 7908.39, "standard_charge_percentage": 70.0000, "estimated_amount": 7908, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 9038.16, "standard_charge_percentage": 80.0000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 10167.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10167, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 11071.8, "standard_charge_percentage": 98.0000, "estimated_amount": 11071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 9603.05, "standard_charge_percentage": 85.0000, "estimated_amount": 9603, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 4519.08, "standard_charge_percentage": 40.0000, "estimated_amount": 4519, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 10732.8, "standard_charge_percentage": 95.0000, "estimated_amount": 10732, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 6778.62, "standard_charge_percentage": 60.0000, "estimated_amount": 6778, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 9038.16, "standard_charge_percentage": 80.0000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 7908.39, "standard_charge_percentage": 70.0000, "estimated_amount": 7908, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 8473.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8473, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 9264.11, "standard_charge_percentage": 82.0000, "estimated_amount": 9264, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 6326.71, "standard_charge_percentage": 56.0000, "estimated_amount": 6326, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 8473.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 8473.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 9038.16, "standard_charge_percentage": 80.0000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 5648.85, "standard_charge_percentage": 50.0000, "estimated_amount": 5648, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 10167.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 9038.16, "standard_charge_percentage": 80.0000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 9038.16, "standard_charge_percentage": 80.0000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 9038.16, "standard_charge_percentage": 80.0000, "estimated_amount": 9038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3389.31, "standard_charge_percentage": 30.0000, "estimated_amount": 3389, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 7908.39, "standard_charge_percentage": 70.0000, "estimated_amount": 7908, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 10167.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 6778.62, "standard_charge_percentage": 60.0000, "estimated_amount": 6778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" }]}]} , { "description": "CYSTOSCOPY CHEMODENERVATION", "code_information": [ { "code": "11720", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 271.93, "discounted_cash": 72,"minimum": 50.63,"maximum": 271.93,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 72.91, "estimated_amount": 72, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 50.63, "estimated_amount": 50, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 271.93, "estimated_amount": 271, "methodology": "case rate" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 237.94, "standard_charge_percentage": 87.5000, "estimated_amount": 237, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 237.94, "standard_charge_percentage": 87.5000, "estimated_amount": 237, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 217.54, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 217.54, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 271.93, "standard_charge_percentage": 100.0000, "estimated_amount": 271, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 258.33, "standard_charge_percentage": 95.0000, "estimated_amount": 258, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 163.16, "standard_charge_percentage": 60.0000, "estimated_amount": 163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 217.54, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 217.54, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 81.58, "standard_charge_percentage": 30.0000, "estimated_amount": 81, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 190.35, "standard_charge_percentage": 70.0000, "estimated_amount": 190, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 222.98, "standard_charge_percentage": 82.0000, "estimated_amount": 222, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 244.74, "standard_charge_percentage": 90.0000, "estimated_amount": 244, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 244.74, "standard_charge_percentage": 90.0000, "estimated_amount": 244, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 266.49, "standard_charge_percentage": 98.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 163.16, "standard_charge_percentage": 60.0000, "estimated_amount": 163, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 58.66, "estimated_amount": 58, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 103.36, "estimated_amount": 103, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 50.63, "estimated_amount": 50, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 72.4, "estimated_amount": 72, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 135.97, "standard_charge_percentage": 50.0000, "estimated_amount": 135, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 231.14, "standard_charge_percentage": 85.0000, "estimated_amount": 231, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 271.93, "standard_charge_percentage": 100.0000, "estimated_amount": 271, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 217.54, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 203.95, "standard_charge_percentage": 75.0000, "estimated_amount": 203, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 152.28, "standard_charge_percentage": 56.0000, "estimated_amount": 152, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 157.72, "standard_charge_percentage": 58.0000, "estimated_amount": 157, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 203.95, "standard_charge_percentage": 75.0000, "estimated_amount": 203, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 197.83, "estimated_amount": 197, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 58.66, "estimated_amount": 58, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 111.74, "estimated_amount": 111, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 57.63, "estimated_amount": 57, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 73.41, "estimated_amount": 73, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 217.54, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 203.95, "standard_charge_percentage": 75.0000, "estimated_amount": 203, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 217.54, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 217.54, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 190.35, "standard_charge_percentage": 70.0000, "estimated_amount": 190, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 190.35, "standard_charge_percentage": 70.0000, "estimated_amount": 190, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 100.61, "standard_charge_percentage": 37.0000, "estimated_amount": 100, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 217.54, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 89.39, "estimated_amount": 89, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 78.22, "estimated_amount": 78, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 89.39, "estimated_amount": 89, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 203.95, "standard_charge_percentage": 75.0000, "estimated_amount": 203, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 217.54, "standard_charge_percentage": 80.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 244.74, "standard_charge_percentage": 90.0000, "estimated_amount": 244, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 244.74, "standard_charge_percentage": 90.0000, "estimated_amount": 244, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 244.74, "standard_charge_percentage": 90.0000, "estimated_amount": 244, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 108.77, "standard_charge_percentage": 40.0000, "estimated_amount": 108, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 203.95, "standard_charge_percentage": 75.0000, "estimated_amount": 203, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 78.22, "estimated_amount": 78, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 56.99, "estimated_amount": 56, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 75.42, "estimated_amount": 75, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" }]}]} , { "description": "Hc Debridement Of Nails, 6 Or More", "code_information": [ { "code": "11721", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 314.38, "discounted_cash": 72,"minimum": 50.63,"maximum": 314.38,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 57.63, "estimated_amount": 57, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 50.63, "estimated_amount": 50, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 314.38, "estimated_amount": 314, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 235.78, "standard_charge_percentage": 75.0000, "estimated_amount": 235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 157.19, "standard_charge_percentage": 50.0000, "estimated_amount": 157, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 282.94, "standard_charge_percentage": 90.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 314.38, "standard_charge_percentage": 100.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 220.07, "standard_charge_percentage": 70.0000, "estimated_amount": 220, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 182.34, "standard_charge_percentage": 58.0000, "estimated_amount": 182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 251.5, "standard_charge_percentage": 80.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 235.78, "standard_charge_percentage": 75.0000, "estimated_amount": 235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 188.63, "standard_charge_percentage": 60.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 78.22, "estimated_amount": 78, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 58.66, "estimated_amount": 58, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 78.22, "estimated_amount": 78, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 111.74, "estimated_amount": 111, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 72.91, "estimated_amount": 72, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 50.63, "estimated_amount": 50, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 282.94, "standard_charge_percentage": 90.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 275.08, "standard_charge_percentage": 87.5000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 235.78, "standard_charge_percentage": 75.0000, "estimated_amount": 235, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 220.07, "standard_charge_percentage": 70.0000, "estimated_amount": 220, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 116.32, "standard_charge_percentage": 37.0000, "estimated_amount": 116, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 282.94, "standard_charge_percentage": 90.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 308.09, "standard_charge_percentage": 98.0000, "estimated_amount": 308, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 197.83, "estimated_amount": 197, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 58.66, "estimated_amount": 58, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 103.36, "estimated_amount": 103, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 89.39, "estimated_amount": 89, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 72.4, "estimated_amount": 72, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 275.08, "standard_charge_percentage": 87.5000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 298.66, "standard_charge_percentage": 95.0000, "estimated_amount": 298, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 188.63, "standard_charge_percentage": 60.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 251.5, "standard_charge_percentage": 80.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 251.5, "standard_charge_percentage": 80.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 282.94, "standard_charge_percentage": 90.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 75.42, "estimated_amount": 75, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 89.39, "estimated_amount": 89, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 73.41, "estimated_amount": 73, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 251.5, "standard_charge_percentage": 80.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 235.78, "standard_charge_percentage": 75.0000, "estimated_amount": 235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 251.5, "standard_charge_percentage": 80.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 282.94, "standard_charge_percentage": 90.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 267.22, "standard_charge_percentage": 85.0000, "estimated_amount": 267, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 125.75, "standard_charge_percentage": 40.0000, "estimated_amount": 125, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 251.5, "standard_charge_percentage": 80.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 251.5, "standard_charge_percentage": 80.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 251.5, "standard_charge_percentage": 80.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 314.38, "standard_charge_percentage": 100.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 251.5, "standard_charge_percentage": 80.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 251.5, "standard_charge_percentage": 80.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 94.31, "standard_charge_percentage": 30.0000, "estimated_amount": 94, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 220.07, "standard_charge_percentage": 70.0000, "estimated_amount": 220, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 235.78, "standard_charge_percentage": 75.0000, "estimated_amount": 235, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 257.79, "standard_charge_percentage": 82.0000, "estimated_amount": 257, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 176.05, "standard_charge_percentage": 56.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 56.99, "estimated_amount": 56, "methodology": "fee schedule" }]}]} , { "description": "Hc Removal Of Nail Plate", "code_information": [ { "code": "11730", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1002.04, "discounted_cash": 242,"minimum": 169.39,"maximum": 1002.04,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 370.75, "standard_charge_percentage": 37.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 951.94, "standard_charge_percentage": 95.0000, "estimated_amount": 951, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 581.18, "standard_charge_percentage": 58.0000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1002.04, "estimated_amount": 1002, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 400.82, "standard_charge_percentage": 40.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 300.61, "standard_charge_percentage": 30.0000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 821.67, "standard_charge_percentage": 82.0000, "estimated_amount": 821, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 260, "estimated_amount": 260, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 851.73, "standard_charge_percentage": 85.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 561.14, "standard_charge_percentage": 56.0000, "estimated_amount": 561, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 982, "standard_charge_percentage": 98.0000, "estimated_amount": 982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" }]}]} , { "description": "Hc Drain Blood From Under Nail", "code_information": [ { "code": "11740", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 629.19, "discounted_cash": 157,"minimum": 109.89,"maximum": 629.19,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 629.19, "estimated_amount": 629, "methodology": "case rate" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 534.81, "standard_charge_percentage": 85.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 352.35, "standard_charge_percentage": 56.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 616.61, "standard_charge_percentage": 98.0000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 251.68, "standard_charge_percentage": 40.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 188.76, "standard_charge_percentage": 30.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 515.94, "standard_charge_percentage": 82.0000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 364.93, "standard_charge_percentage": 58.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 232.8, "standard_charge_percentage": 37.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 260, "estimated_amount": 260, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 597.73, "standard_charge_percentage": 95.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" }]}]} , { "description": "Hc Removal Of Nail Bed", "code_information": [ { "code": "11750", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 286,"maximum": 1928.66,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" }]}]} , { "description": "Hc Reconstruc Of Nail Bed", "code_information": [ { "code": "11760", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2922.44, "discounted_cash": 748,"minimum": 286,"maximum": 2922.44,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1636.57, "standard_charge_percentage": 56.0000, "estimated_amount": 1636, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1753.46, "standard_charge_percentage": 60.0000, "estimated_amount": 1753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1461.22, "standard_charge_percentage": 50.0000, "estimated_amount": 1461, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2557.14, "standard_charge_percentage": 87.5000, "estimated_amount": 2557, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2776.32, "standard_charge_percentage": 95.0000, "estimated_amount": 2776, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2922.44, "standard_charge_percentage": 100.0000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1753.46, "standard_charge_percentage": 60.0000, "estimated_amount": 1753, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2396.4, "standard_charge_percentage": 82.0000, "estimated_amount": 2396, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1695.02, "standard_charge_percentage": 58.0000, "estimated_amount": 1695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1151.68, "estimated_amount": 1151, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 582.46, "estimated_amount": 582, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 756.65, "estimated_amount": 756, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 746.22, "estimated_amount": 746, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2484.07, "standard_charge_percentage": 85.0000, "estimated_amount": 2484, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1168.98, "standard_charge_percentage": 40.0000, "estimated_amount": 1168, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2557.14, "standard_charge_percentage": 87.5000, "estimated_amount": 2557, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2922.44, "standard_charge_percentage": 100.0000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2863.99, "standard_charge_percentage": 98.0000, "estimated_amount": 2863, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 587.36, "estimated_amount": 587, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 777.38, "estimated_amount": 777, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1065.3, "estimated_amount": 1065, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 751.44, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 876.73, "standard_charge_percentage": 30.0000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1081.3, "standard_charge_percentage": 37.0000, "estimated_amount": 1081, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2038.97, "estimated_amount": 2038, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" }]}]} , { "description": "Hc Excision Of Nail Fold (Wedge), Toe", "code_information": [ { "code": "11765", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1956.59, "discounted_cash": 488,"minimum": 228.8,"maximum": 1956.59,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1858.76, "standard_charge_percentage": 95.0000, "estimated_amount": 1858, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1467.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1604.4, "standard_charge_percentage": 82.0000, "estimated_amount": 1604, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 723.94, "standard_charge_percentage": 37.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1467.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1467.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 978.29, "standard_charge_percentage": 50.0000, "estimated_amount": 978, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1760.93, "standard_charge_percentage": 90.0000, "estimated_amount": 1760, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1712.02, "standard_charge_percentage": 87.5000, "estimated_amount": 1712, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1369.61, "standard_charge_percentage": 70.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1369.61, "standard_charge_percentage": 70.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1095.69, "standard_charge_percentage": 56.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1134.82, "standard_charge_percentage": 58.0000, "estimated_amount": 1134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1663.1, "standard_charge_percentage": 85.0000, "estimated_amount": 1663, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1712.02, "standard_charge_percentage": 87.5000, "estimated_amount": 1712, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1956.59, "standard_charge_percentage": 100.0000, "estimated_amount": 1956, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1956.59, "standard_charge_percentage": 100.0000, "estimated_amount": 1956, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1173.95, "standard_charge_percentage": 60.0000, "estimated_amount": 1173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1369.61, "standard_charge_percentage": 70.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1467.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1760.93, "standard_charge_percentage": 90.0000, "estimated_amount": 1760, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1467.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1173.95, "standard_charge_percentage": 60.0000, "estimated_amount": 1173, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 228.8, "estimated_amount": 228, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1760.93, "standard_charge_percentage": 90.0000, "estimated_amount": 1760, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1760.93, "standard_charge_percentage": 90.0000, "estimated_amount": 1760, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 782.64, "standard_charge_percentage": 40.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 586.98, "standard_charge_percentage": 30.0000, "estimated_amount": 586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1760.93, "standard_charge_percentage": 90.0000, "estimated_amount": 1760, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1917.46, "standard_charge_percentage": 98.0000, "estimated_amount": 1917, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" }]}]} , { "description": "Remove pilonidal cyst exten", "code_information": [ { "code": "11771", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 12688.7, "discounted_cash": 3500,"minimum": 920.5,"maximum": 12688.7,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3488.97, "estimated_amount": 3488, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 9516.52, "standard_charge_percentage": 75.0000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6344.35, "standard_charge_percentage": 50.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 11419.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11419, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 10785.4, "standard_charge_percentage": 85.0000, "estimated_amount": 10785, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 11102.6, "standard_charge_percentage": 87.5000, "estimated_amount": 11102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 12688.7, "standard_charge_percentage": 100.0000, "estimated_amount": 12688, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 12688.7, "standard_charge_percentage": 100.0000, "estimated_amount": 12688, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 8882.09, "standard_charge_percentage": 70.0000, "estimated_amount": 8882, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 7105.67, "standard_charge_percentage": 56.0000, "estimated_amount": 7105, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 7359.45, "standard_charge_percentage": 58.0000, "estimated_amount": 7359, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 9516.52, "standard_charge_percentage": 75.0000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3513.37, "estimated_amount": 3513, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2589.97, "estimated_amount": 2589, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 920.5, "estimated_amount": 920, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3537.77, "estimated_amount": 3537, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 11419.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11419, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 11102.6, "standard_charge_percentage": 87.5000, "estimated_amount": 11102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 12054.3, "standard_charge_percentage": 95.0000, "estimated_amount": 12054, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3806.61, "standard_charge_percentage": 30.0000, "estimated_amount": 3806, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 11419.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11419, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4980.9, "estimated_amount": 4980, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 9516.52, "standard_charge_percentage": 75.0000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 11419.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11419, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 9516.52, "standard_charge_percentage": 75.0000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 10404.7, "standard_charge_percentage": 82.0000, "estimated_amount": 10404, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9533.36, "estimated_amount": 9533, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3634.71, "estimated_amount": 3634, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5384.76, "estimated_amount": 5384, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5075.48, "standard_charge_percentage": 40.0000, "estimated_amount": 5075, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 7613.22, "standard_charge_percentage": 60.0000, "estimated_amount": 7613, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 9516.52, "standard_charge_percentage": 75.0000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 8882.09, "standard_charge_percentage": 70.0000, "estimated_amount": 8882, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 8882.09, "standard_charge_percentage": 70.0000, "estimated_amount": 8882, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 11419.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11419, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 12434.9, "standard_charge_percentage": 98.0000, "estimated_amount": 12434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 7613.22, "standard_charge_percentage": 60.0000, "estimated_amount": 7613, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2746.23, "estimated_amount": 2746, "methodology": "fee schedule" }]}]} , { "description": "Remove pilonidal cyst compl", "code_information": [ { "code": "11772", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9280.75, "discounted_cash": 3500,"minimum": 920.5,"maximum": 9280.75,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6960.56, "standard_charge_percentage": 75.0000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8352.67, "standard_charge_percentage": 90.0000, "estimated_amount": 8352, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8352.67, "standard_charge_percentage": 90.0000, "estimated_amount": 8352, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7888.64, "standard_charge_percentage": 85.0000, "estimated_amount": 7888, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8120.66, "standard_charge_percentage": 87.5000, "estimated_amount": 8120, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7610.22, "standard_charge_percentage": 82.0000, "estimated_amount": 7610, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5197.22, "standard_charge_percentage": 56.0000, "estimated_amount": 5197, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9095.14, "standard_charge_percentage": 98.0000, "estimated_amount": 9095, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4980.9, "estimated_amount": 4980, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6496.52, "standard_charge_percentage": 70.0000, "estimated_amount": 6496, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8352.67, "standard_charge_percentage": 90.0000, "estimated_amount": 8352, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6960.56, "standard_charge_percentage": 75.0000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3513.37, "estimated_amount": 3513, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 920.5, "estimated_amount": 920, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3537.77, "estimated_amount": 3537, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3488.97, "estimated_amount": 3488, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4640.38, "standard_charge_percentage": 50.0000, "estimated_amount": 4640, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8352.67, "standard_charge_percentage": 90.0000, "estimated_amount": 8352, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3712.3, "standard_charge_percentage": 40.0000, "estimated_amount": 3712, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8120.66, "standard_charge_percentage": 87.5000, "estimated_amount": 8120, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8816.71, "standard_charge_percentage": 95.0000, "estimated_amount": 8816, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9280.75, "standard_charge_percentage": 100.0000, "estimated_amount": 9280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2784.22, "standard_charge_percentage": 30.0000, "estimated_amount": 2784, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6496.52, "standard_charge_percentage": 70.0000, "estimated_amount": 6496, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6496.52, "standard_charge_percentage": 70.0000, "estimated_amount": 6496, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6960.56, "standard_charge_percentage": 75.0000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8352.67, "standard_charge_percentage": 90.0000, "estimated_amount": 8352, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9280.75, "estimated_amount": 9280, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3634.71, "estimated_amount": 3634, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5384.76, "estimated_amount": 5384, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2589.97, "estimated_amount": 2589, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6960.56, "standard_charge_percentage": 75.0000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9280.75, "standard_charge_percentage": 100.0000, "estimated_amount": 9280, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5568.45, "standard_charge_percentage": 60.0000, "estimated_amount": 5568, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6960.56, "standard_charge_percentage": 75.0000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5382.84, "standard_charge_percentage": 58.0000, "estimated_amount": 5382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5568.45, "standard_charge_percentage": 60.0000, "estimated_amount": 5568, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2746.23, "estimated_amount": 2746, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr <2.5 Cm", "code_information": [ { "code": "12001", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1002.04, "discounted_cash": 242,"minimum": 169.39,"maximum": 1002.04,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1002.04, "estimated_amount": 1002, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 821.67, "standard_charge_percentage": 82.0000, "estimated_amount": 821, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 207.48, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 951.94, "standard_charge_percentage": 95.0000, "estimated_amount": 951, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 300.61, "standard_charge_percentage": 30.0000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 851.73, "standard_charge_percentage": 85.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 400.82, "standard_charge_percentage": 40.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 561.14, "standard_charge_percentage": 56.0000, "estimated_amount": 561, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 581.18, "standard_charge_percentage": 58.0000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 370.75, "standard_charge_percentage": 37.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 982, "standard_charge_percentage": 98.0000, "estimated_amount": 982, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr 2.6-7.5 Cm", "code_information": [ { "code": "12002", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1002.04, "discounted_cash": 242,"minimum": 169.39,"maximum": 1002.04,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 260, "estimated_amount": 260, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 851.73, "standard_charge_percentage": 85.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 821.67, "standard_charge_percentage": 82.0000, "estimated_amount": 821, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 581.18, "standard_charge_percentage": 58.0000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 561.14, "standard_charge_percentage": 56.0000, "estimated_amount": 561, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 982, "standard_charge_percentage": 98.0000, "estimated_amount": 982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 951.94, "standard_charge_percentage": 95.0000, "estimated_amount": 951, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 400.82, "standard_charge_percentage": 40.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 300.61, "standard_charge_percentage": 30.0000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 370.75, "standard_charge_percentage": 37.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr 7.6-12.5 Cm", "code_information": [ { "code": "12004", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 876.59, "discounted_cash": 242,"minimum": 169.39,"maximum": 876.59,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 207.48, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 876.59, "estimated_amount": 876, "methodology": "case rate" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 767.02, "standard_charge_percentage": 87.5000, "estimated_amount": 767, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 701.27, "standard_charge_percentage": 80.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 701.27, "standard_charge_percentage": 80.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 701.27, "standard_charge_percentage": 80.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 876.59, "standard_charge_percentage": 100.0000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 525.95, "standard_charge_percentage": 60.0000, "estimated_amount": 525, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 657.44, "standard_charge_percentage": 75.0000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 701.27, "standard_charge_percentage": 80.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 657.44, "standard_charge_percentage": 75.0000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 788.93, "standard_charge_percentage": 90.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 788.93, "standard_charge_percentage": 90.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 745.1, "standard_charge_percentage": 85.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 767.02, "standard_charge_percentage": 87.5000, "estimated_amount": 767, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 701.27, "standard_charge_percentage": 80.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 262.98, "standard_charge_percentage": 30.0000, "estimated_amount": 262, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 613.61, "standard_charge_percentage": 70.0000, "estimated_amount": 613, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 788.93, "standard_charge_percentage": 90.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 657.44, "standard_charge_percentage": 75.0000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 701.27, "standard_charge_percentage": 80.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 438.3, "standard_charge_percentage": 50.0000, "estimated_amount": 438, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 350.64, "standard_charge_percentage": 40.0000, "estimated_amount": 350, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 832.76, "standard_charge_percentage": 95.0000, "estimated_amount": 832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 701.27, "standard_charge_percentage": 80.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 701.27, "standard_charge_percentage": 80.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 701.27, "standard_charge_percentage": 80.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 613.61, "standard_charge_percentage": 70.0000, "estimated_amount": 613, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 718.8, "standard_charge_percentage": 82.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 490.89, "standard_charge_percentage": 56.0000, "estimated_amount": 490, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 324.34, "standard_charge_percentage": 37.0000, "estimated_amount": 324, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 657.44, "standard_charge_percentage": 75.0000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 525.95, "standard_charge_percentage": 60.0000, "estimated_amount": 525, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 788.93, "standard_charge_percentage": 90.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 876.59, "standard_charge_percentage": 100.0000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 657.44, "standard_charge_percentage": 75.0000, "estimated_amount": 657, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 613.61, "standard_charge_percentage": 70.0000, "estimated_amount": 613, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 508.42, "standard_charge_percentage": 58.0000, "estimated_amount": 508, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 701.27, "standard_charge_percentage": 80.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 788.93, "standard_charge_percentage": 90.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 859.06, "standard_charge_percentage": 98.0000, "estimated_amount": 859, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr 12.6-20 Cm", "code_information": [ { "code": "12005", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 240.24,"maximum": 1928.66,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1928.66, "estimated_amount": 1928, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 240.24, "estimated_amount": 240, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Body/Scalp/Extr 20.1-30 Cm", "code_information": [ { "code": "12006", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 252.25,"maximum": 1928.66,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 252.25, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1928.66, "estimated_amount": 1928, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Face 2.6-5.0 Cm", "code_information": [ { "code": "12013", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1002.04, "discounted_cash": 242,"minimum": 169.39,"maximum": 1002.04,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 370.75, "standard_charge_percentage": 37.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 982, "standard_charge_percentage": 98.0000, "estimated_amount": 982, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 851.73, "standard_charge_percentage": 85.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 400.82, "standard_charge_percentage": 40.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 951.94, "standard_charge_percentage": 95.0000, "estimated_amount": 951, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 561.14, "standard_charge_percentage": 56.0000, "estimated_amount": 561, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 581.18, "standard_charge_percentage": 58.0000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 336.96, "estimated_amount": 336, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 300.61, "standard_charge_percentage": 30.0000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 821.67, "standard_charge_percentage": 82.0000, "estimated_amount": 821, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Face 5.1-7.5 Cm", "code_information": [ { "code": "12014", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1002.04, "discounted_cash": 242,"minimum": 169.39,"maximum": 1002.04,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1002.04, "estimated_amount": 1002, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 851.73, "standard_charge_percentage": 85.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 821.67, "standard_charge_percentage": 82.0000, "estimated_amount": 821, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 581.18, "standard_charge_percentage": 58.0000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 982, "standard_charge_percentage": 98.0000, "estimated_amount": 982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 336.96, "estimated_amount": 336, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 400.82, "standard_charge_percentage": 40.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 300.61, "standard_charge_percentage": 30.0000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 370.75, "standard_charge_percentage": 37.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 951.94, "standard_charge_percentage": 95.0000, "estimated_amount": 951, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 561.14, "standard_charge_percentage": 56.0000, "estimated_amount": 561, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Smp Face 7.6-12.5 Cm", "code_information": [ { "code": "12015", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1002.04, "discounted_cash": 242,"minimum": 169.39,"maximum": 1002.04,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 951.94, "standard_charge_percentage": 95.0000, "estimated_amount": 951, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 300.61, "standard_charge_percentage": 30.0000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 561.14, "standard_charge_percentage": 56.0000, "estimated_amount": 561, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 336.96, "estimated_amount": 336, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1002.04, "estimated_amount": 1002, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 821.67, "standard_charge_percentage": 82.0000, "estimated_amount": 821, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 851.73, "standard_charge_percentage": 85.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 400.82, "standard_charge_percentage": 40.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 581.18, "standard_charge_percentage": 58.0000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 370.75, "standard_charge_percentage": 37.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 982, "standard_charge_percentage": 98.0000, "estimated_amount": 982, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" }]}]} , { "description": "Hc Treat Wnd Dehiscence, Simple Closure", "code_information": [ { "code": "12020", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3081.76, "discounted_cash": 748,"minimum": 370.66,"maximum": 3081.76,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 751.44, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 582.46, "estimated_amount": 582, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 756.65, "estimated_amount": 756, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2311.32, "standard_charge_percentage": 75.0000, "estimated_amount": 2311, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2465.41, "standard_charge_percentage": 80.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2465.41, "standard_charge_percentage": 80.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1540.88, "standard_charge_percentage": 50.0000, "estimated_amount": 1540, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2619.5, "standard_charge_percentage": 85.0000, "estimated_amount": 2619, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1232.7, "standard_charge_percentage": 40.0000, "estimated_amount": 1232, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2465.41, "standard_charge_percentage": 80.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2927.67, "standard_charge_percentage": 95.0000, "estimated_amount": 2927, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2465.41, "standard_charge_percentage": 80.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1725.79, "standard_charge_percentage": 56.0000, "estimated_amount": 1725, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 587.36, "estimated_amount": 587, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 777.38, "estimated_amount": 777, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1065.3, "estimated_amount": 1065, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1151.68, "estimated_amount": 1151, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 370.66, "estimated_amount": 370, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2773.58, "standard_charge_percentage": 90.0000, "estimated_amount": 2773, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2465.41, "standard_charge_percentage": 80.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3081.76, "standard_charge_percentage": 100.0000, "estimated_amount": 3081, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2465.41, "standard_charge_percentage": 80.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2465.41, "standard_charge_percentage": 80.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2311.32, "standard_charge_percentage": 75.0000, "estimated_amount": 2311, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2157.23, "standard_charge_percentage": 70.0000, "estimated_amount": 2157, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2157.23, "standard_charge_percentage": 70.0000, "estimated_amount": 2157, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2311.32, "standard_charge_percentage": 75.0000, "estimated_amount": 2311, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2527.04, "standard_charge_percentage": 82.0000, "estimated_amount": 2527, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1787.42, "standard_charge_percentage": 58.0000, "estimated_amount": 1787, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1140.25, "standard_charge_percentage": 37.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2465.41, "standard_charge_percentage": 80.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2773.58, "standard_charge_percentage": 90.0000, "estimated_amount": 2773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2773.58, "standard_charge_percentage": 90.0000, "estimated_amount": 2773, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2696.54, "standard_charge_percentage": 87.5000, "estimated_amount": 2696, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2465.41, "standard_charge_percentage": 80.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2465.41, "standard_charge_percentage": 80.0000, "estimated_amount": 2465, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3020.12, "standard_charge_percentage": 98.0000, "estimated_amount": 3020, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2311.32, "standard_charge_percentage": 75.0000, "estimated_amount": 2311, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 746.22, "estimated_amount": 746, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2311.32, "standard_charge_percentage": 75.0000, "estimated_amount": 2311, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2773.58, "standard_charge_percentage": 90.0000, "estimated_amount": 2773, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2696.54, "standard_charge_percentage": 87.5000, "estimated_amount": 2696, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3081.76, "standard_charge_percentage": 100.0000, "estimated_amount": 3081, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1849.06, "standard_charge_percentage": 60.0000, "estimated_amount": 1849, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 924.53, "standard_charge_percentage": 30.0000, "estimated_amount": 924, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2157.23, "standard_charge_percentage": 70.0000, "estimated_amount": 2157, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2773.58, "standard_charge_percentage": 90.0000, "estimated_amount": 2773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1849.06, "standard_charge_percentage": 60.0000, "estimated_amount": 1849, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2038.97, "estimated_amount": 2038, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Body/Scalp/Extr <2.5 Cm", "code_information": [ { "code": "12031", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 286,"maximum": 1928.66,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Body/Scalp/Extr 2.6-7.5 Cm", "code_information": [ { "code": "12032", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1910.36, "discounted_cash": 488,"minimum": 286,"maximum": 1910.36,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1432.77, "standard_charge_percentage": 75.0000, "estimated_amount": 1432, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 80.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 80.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1719.32, "standard_charge_percentage": 90.0000, "estimated_amount": 1719, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1623.81, "standard_charge_percentage": 85.0000, "estimated_amount": 1623, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1671.57, "standard_charge_percentage": 87.5000, "estimated_amount": 1671, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 80.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1910.36, "standard_charge_percentage": 100.0000, "estimated_amount": 1910, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1146.22, "standard_charge_percentage": 60.0000, "estimated_amount": 1146, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 80.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1719.32, "standard_charge_percentage": 90.0000, "estimated_amount": 1719, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1719.32, "standard_charge_percentage": 90.0000, "estimated_amount": 1719, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1146.22, "standard_charge_percentage": 60.0000, "estimated_amount": 1146, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 764.14, "standard_charge_percentage": 40.0000, "estimated_amount": 764, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1910.36, "standard_charge_percentage": 100.0000, "estimated_amount": 1910, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 80.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 573.11, "standard_charge_percentage": 30.0000, "estimated_amount": 573, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1432.77, "standard_charge_percentage": 75.0000, "estimated_amount": 1432, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1432.77, "standard_charge_percentage": 75.0000, "estimated_amount": 1432, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1432.77, "standard_charge_percentage": 75.0000, "estimated_amount": 1432, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 955.18, "standard_charge_percentage": 50.0000, "estimated_amount": 955, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1719.32, "standard_charge_percentage": 90.0000, "estimated_amount": 1719, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1671.57, "standard_charge_percentage": 87.5000, "estimated_amount": 1671, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 80.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 80.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 80.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1337.25, "standard_charge_percentage": 70.0000, "estimated_amount": 1337, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1337.25, "standard_charge_percentage": 70.0000, "estimated_amount": 1337, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1069.8, "standard_charge_percentage": 56.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1108.01, "standard_charge_percentage": 58.0000, "estimated_amount": 1108, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 706.83, "standard_charge_percentage": 37.0000, "estimated_amount": 706, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1872.15, "standard_charge_percentage": 98.0000, "estimated_amount": 1872, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1432.77, "standard_charge_percentage": 75.0000, "estimated_amount": 1432, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1719.32, "standard_charge_percentage": 90.0000, "estimated_amount": 1719, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 80.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1814.84, "standard_charge_percentage": 95.0000, "estimated_amount": 1814, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1528.29, "standard_charge_percentage": 80.0000, "estimated_amount": 1528, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1337.25, "standard_charge_percentage": 70.0000, "estimated_amount": 1337, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1566.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1566, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Body/Scalp/Extr 7.6-12.5 Cm", "code_information": [ { "code": "12034", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 286,"maximum": 1928.66,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1928.66, "estimated_amount": 1928, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent <2.5 Cm", "code_information": [ { "code": "12041", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 257.4,"maximum": 1928.66,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 257.4, "estimated_amount": 257, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 2.6-7.5 Cm", "code_information": [ { "code": "12042", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 286,"maximum": 1928.66,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 7.6-12.5 Cm", "code_information": [ { "code": "12044", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2922.44, "discounted_cash": 748,"minimum": 343.2,"maximum": 2922.44,"payers_information":[{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1168.98, "standard_charge_percentage": 40.0000, "estimated_amount": 1168, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2922.44, "standard_charge_percentage": 100.0000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1636.57, "standard_charge_percentage": 56.0000, "estimated_amount": 1636, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1753.46, "standard_charge_percentage": 60.0000, "estimated_amount": 1753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 587.36, "estimated_amount": 587, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 777.38, "estimated_amount": 777, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 751.44, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 343.2, "estimated_amount": 343, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 756.65, "estimated_amount": 756, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2396.4, "standard_charge_percentage": 82.0000, "estimated_amount": 2396, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1081.3, "standard_charge_percentage": 37.0000, "estimated_amount": 1081, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2038.97, "estimated_amount": 2038, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1461.22, "standard_charge_percentage": 50.0000, "estimated_amount": 1461, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2776.32, "standard_charge_percentage": 95.0000, "estimated_amount": 2776, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2922.44, "standard_charge_percentage": 100.0000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 876.73, "standard_charge_percentage": 30.0000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1695.02, "standard_charge_percentage": 58.0000, "estimated_amount": 1695, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 582.46, "estimated_amount": 582, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 746.22, "estimated_amount": 746, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2484.07, "standard_charge_percentage": 85.0000, "estimated_amount": 2484, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2557.14, "standard_charge_percentage": 87.5000, "estimated_amount": 2557, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2557.14, "standard_charge_percentage": 87.5000, "estimated_amount": 2557, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1753.46, "standard_charge_percentage": 60.0000, "estimated_amount": 1753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2863.99, "standard_charge_percentage": 98.0000, "estimated_amount": 2863, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1065.3, "estimated_amount": 1065, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1151.68, "estimated_amount": 1151, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Neck/Hnd/Ft/Gent 12.5-20 Cm", "code_information": [ { "code": "12045", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2922.44, "discounted_cash": 748,"minimum": 286,"maximum": 2922.44,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 756.65, "estimated_amount": 756, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2557.14, "standard_charge_percentage": 87.5000, "estimated_amount": 2557, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2863.99, "standard_charge_percentage": 98.0000, "estimated_amount": 2863, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2038.97, "estimated_amount": 2038, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1065.3, "estimated_amount": 1065, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 746.22, "estimated_amount": 746, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1461.22, "standard_charge_percentage": 50.0000, "estimated_amount": 1461, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2484.07, "standard_charge_percentage": 85.0000, "estimated_amount": 2484, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2922.44, "standard_charge_percentage": 100.0000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 876.73, "standard_charge_percentage": 30.0000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1081.3, "standard_charge_percentage": 37.0000, "estimated_amount": 1081, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2557.14, "standard_charge_percentage": 87.5000, "estimated_amount": 2557, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2396.4, "standard_charge_percentage": 82.0000, "estimated_amount": 2396, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1636.57, "standard_charge_percentage": 56.0000, "estimated_amount": 1636, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1753.46, "standard_charge_percentage": 60.0000, "estimated_amount": 1753, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 587.36, "estimated_amount": 587, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 777.38, "estimated_amount": 777, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1151.68, "estimated_amount": 1151, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 751.44, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 582.46, "estimated_amount": 582, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1168.98, "standard_charge_percentage": 40.0000, "estimated_amount": 1168, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2776.32, "standard_charge_percentage": 95.0000, "estimated_amount": 2776, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2922.44, "standard_charge_percentage": 100.0000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1753.46, "standard_charge_percentage": 60.0000, "estimated_amount": 1753, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1695.02, "standard_charge_percentage": 58.0000, "estimated_amount": 1695, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Face <2.5 Cm", "code_information": [ { "code": "12051", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 340.59,"maximum": 1928.66,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 343.2, "estimated_amount": 343, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Face 2.6-5.0 Cm", "code_information": [ { "code": "12052", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1928.66, "discounted_cash": 488,"minimum": 340.59,"maximum": 1928.66,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1118.62, "standard_charge_percentage": 58.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 964.33, "standard_charge_percentage": 50.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1832.23, "standard_charge_percentage": 95.0000, "estimated_amount": 1832, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1581.5, "standard_charge_percentage": 82.0000, "estimated_amount": 1581, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 713.6, "standard_charge_percentage": 37.0000, "estimated_amount": 713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 343.2, "estimated_amount": 343, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1639.36, "standard_charge_percentage": 85.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1687.58, "standard_charge_percentage": 87.5000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1350.06, "standard_charge_percentage": 70.0000, "estimated_amount": 1350, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1446.49, "standard_charge_percentage": 75.0000, "estimated_amount": 1446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1080.05, "standard_charge_percentage": 56.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1157.2, "standard_charge_percentage": 60.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 771.46, "standard_charge_percentage": 40.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1928.66, "standard_charge_percentage": 100.0000, "estimated_amount": 1928, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 578.6, "standard_charge_percentage": 30.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1542.93, "standard_charge_percentage": 80.0000, "estimated_amount": 1542, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1735.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1735, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1890.09, "standard_charge_percentage": 98.0000, "estimated_amount": 1890, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Face 5.1-7.5 Cm", "code_information": [ { "code": "12053", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1997.65, "discounted_cash": 488,"minimum": 340.59,"maximum": 1997.65,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1498.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1747.94, "standard_charge_percentage": 87.5000, "estimated_amount": 1747, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1747.94, "standard_charge_percentage": 87.5000, "estimated_amount": 1747, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1997.65, "standard_charge_percentage": 100.0000, "estimated_amount": 1997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 599.29, "standard_charge_percentage": 30.0000, "estimated_amount": 599, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1398.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1398, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1498.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 343.2, "estimated_amount": 343, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1797.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1797, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1997.65, "standard_charge_percentage": 100.0000, "estimated_amount": 1997, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1398.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1398, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1498.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1797.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1797, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1797.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1797, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1498.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 998.83, "standard_charge_percentage": 50.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1198.59, "standard_charge_percentage": 60.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1797.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1797, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1797.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1797, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1698, "standard_charge_percentage": 85.0000, "estimated_amount": 1698, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 799.06, "standard_charge_percentage": 40.0000, "estimated_amount": 799, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1897.77, "standard_charge_percentage": 95.0000, "estimated_amount": 1897, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1498.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1398.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1398, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1638.07, "standard_charge_percentage": 82.0000, "estimated_amount": 1638, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1118.68, "standard_charge_percentage": 56.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1158.64, "standard_charge_percentage": 58.0000, "estimated_amount": 1158, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 739.13, "standard_charge_percentage": 37.0000, "estimated_amount": 739, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1957.7, "standard_charge_percentage": 98.0000, "estimated_amount": 1957, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1198.59, "standard_charge_percentage": 60.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Intrmd Face 7.6-12.5 Cm", "code_information": [ { "code": "12054", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1956.59, "discounted_cash": 488,"minimum": 340.59,"maximum": 1956.59,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1369.61, "standard_charge_percentage": 70.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1369.61, "standard_charge_percentage": 70.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1095.69, "standard_charge_percentage": 56.0000, "estimated_amount": 1095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1467.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1604.4, "standard_charge_percentage": 82.0000, "estimated_amount": 1604, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 343.2, "estimated_amount": 343, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1956.59, "estimated_amount": 1956, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1467.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1760.93, "standard_charge_percentage": 90.0000, "estimated_amount": 1760, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1760.93, "standard_charge_percentage": 90.0000, "estimated_amount": 1760, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1663.1, "standard_charge_percentage": 85.0000, "estimated_amount": 1663, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 782.64, "standard_charge_percentage": 40.0000, "estimated_amount": 782, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1858.76, "standard_charge_percentage": 95.0000, "estimated_amount": 1858, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 586.98, "standard_charge_percentage": 30.0000, "estimated_amount": 586, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1134.82, "standard_charge_percentage": 58.0000, "estimated_amount": 1134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1760.93, "standard_charge_percentage": 90.0000, "estimated_amount": 1760, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1917.46, "standard_charge_percentage": 98.0000, "estimated_amount": 1917, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1467.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 978.29, "standard_charge_percentage": 50.0000, "estimated_amount": 978, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1760.93, "standard_charge_percentage": 90.0000, "estimated_amount": 1760, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1712.02, "standard_charge_percentage": 87.5000, "estimated_amount": 1712, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1712.02, "standard_charge_percentage": 87.5000, "estimated_amount": 1712, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1956.59, "standard_charge_percentage": 100.0000, "estimated_amount": 1956, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1956.59, "standard_charge_percentage": 100.0000, "estimated_amount": 1956, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1173.95, "standard_charge_percentage": 60.0000, "estimated_amount": 1173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1565.27, "standard_charge_percentage": 80.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1369.61, "standard_charge_percentage": 70.0000, "estimated_amount": 1369, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1467.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 723.94, "standard_charge_percentage": 37.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1760.93, "standard_charge_percentage": 90.0000, "estimated_amount": 1760, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1467.44, "standard_charge_percentage": 75.0000, "estimated_amount": 1467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1173.95, "standard_charge_percentage": 60.0000, "estimated_amount": 1173, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Cplx Face/Hnd/Ft/Gent 1.1-2.5 Cm", "code_information": [ { "code": "13131", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1997.65, "discounted_cash": 488,"minimum": 286,"maximum": 1997.65,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 490.45, "estimated_amount": 490, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1698, "standard_charge_percentage": 85.0000, "estimated_amount": 1698, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1747.94, "standard_charge_percentage": 87.5000, "estimated_amount": 1747, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1997.65, "standard_charge_percentage": 100.0000, "estimated_amount": 1997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1498.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1398.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1398, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1498.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1118.68, "standard_charge_percentage": 56.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1797.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1797, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1498.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 507.38, "estimated_amount": 507, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 695.3, "estimated_amount": 695, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1498.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1498.24, "standard_charge_percentage": 75.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 998.83, "standard_charge_percentage": 50.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1797.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1797, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 799.06, "standard_charge_percentage": 40.0000, "estimated_amount": 799, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1997.65, "standard_charge_percentage": 100.0000, "estimated_amount": 1997, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 739.13, "standard_charge_percentage": 37.0000, "estimated_amount": 739, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1198.59, "standard_charge_percentage": 60.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1330.8, "estimated_amount": 1330, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 374.03, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 487.04, "estimated_amount": 487, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1747.94, "standard_charge_percentage": 87.5000, "estimated_amount": 1747, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 599.29, "standard_charge_percentage": 30.0000, "estimated_amount": 599, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1398.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1398, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1638.07, "standard_charge_percentage": 82.0000, "estimated_amount": 1638, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1158.64, "standard_charge_percentage": 58.0000, "estimated_amount": 1158, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1957.7, "standard_charge_percentage": 98.0000, "estimated_amount": 1957, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 383.36, "estimated_amount": 383, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.59, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.86, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1997.65, "estimated_amount": 1997, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1797.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1797, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1797.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1797, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1897.77, "standard_charge_percentage": 95.0000, "estimated_amount": 1897, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1198.59, "standard_charge_percentage": 60.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1398.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1398, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1598.12, "standard_charge_percentage": 80.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1797.88, "standard_charge_percentage": 90.0000, "estimated_amount": 1797, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 526.18, "estimated_amount": 526, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.63, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.84, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 601.34, "estimated_amount": 601, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 751.68, "estimated_amount": 751, "methodology": "fee schedule" }]}]} , { "description": "Hc Repr Wnd Cplx Face/Hnd/Ft/Gent 2.6-7.5 Cm", "code_information": [ { "code": "13132", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2922.44, "discounted_cash": 748,"minimum": 286,"maximum": 2922.44,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 756.65, "estimated_amount": 756, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2922.44, "estimated_amount": 2922, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1168.98, "standard_charge_percentage": 40.0000, "estimated_amount": 1168, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2863.99, "standard_charge_percentage": 98.0000, "estimated_amount": 2863, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1065.3, "estimated_amount": 1065, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 751.44, "estimated_amount": 751, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 746.22, "estimated_amount": 746, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2484.07, "standard_charge_percentage": 85.0000, "estimated_amount": 2484, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2776.32, "standard_charge_percentage": 95.0000, "estimated_amount": 2776, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2922.44, "standard_charge_percentage": 100.0000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 876.73, "standard_charge_percentage": 30.0000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2396.4, "standard_charge_percentage": 82.0000, "estimated_amount": 2396, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1081.3, "standard_charge_percentage": 37.0000, "estimated_amount": 1081, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2038.97, "estimated_amount": 2038, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1461.22, "standard_charge_percentage": 50.0000, "estimated_amount": 1461, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1636.57, "standard_charge_percentage": 56.0000, "estimated_amount": 1636, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1695.02, "standard_charge_percentage": 58.0000, "estimated_amount": 1695, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1753.46, "standard_charge_percentage": 60.0000, "estimated_amount": 1753, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 921.34, "estimated_amount": 921, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 604.63, "estimated_amount": 604, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 521.83, "estimated_amount": 521, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 582.46, "estimated_amount": 582, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2191.83, "standard_charge_percentage": 75.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2630.2, "standard_charge_percentage": 90.0000, "estimated_amount": 2630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2557.14, "standard_charge_percentage": 87.5000, "estimated_amount": 2557, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2557.14, "standard_charge_percentage": 87.5000, "estimated_amount": 2557, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2922.44, "standard_charge_percentage": 100.0000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1753.46, "standard_charge_percentage": 60.0000, "estimated_amount": 1753, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2337.95, "standard_charge_percentage": 80.0000, "estimated_amount": 2337, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2045.71, "standard_charge_percentage": 70.0000, "estimated_amount": 2045, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 806.18, "estimated_amount": 806, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 587.36, "estimated_amount": 587, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 777.38, "estimated_amount": 777, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 575.84, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1151.68, "estimated_amount": 1151, "methodology": "fee schedule" }]}]} , { "description": "Sec Clsr Surg Wnd/Dehsn Xtn", "code_information": [ { "code": "13160", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8799.1, "discounted_cash": 2237,"minimum": 590.76,"maximum": 8799.1,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3519.64, "standard_charge_percentage": 40.0000, "estimated_amount": 3519, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7699.21, "standard_charge_percentage": 87.5000, "estimated_amount": 7699, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8359.15, "standard_charge_percentage": 95.0000, "estimated_amount": 8359, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6159.37, "standard_charge_percentage": 70.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2245.51, "estimated_amount": 2245, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1730.35, "estimated_amount": 1730, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2229.91, "estimated_amount": 2229, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7479.23, "standard_charge_percentage": 85.0000, "estimated_amount": 7479, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8799.1, "standard_charge_percentage": 100.0000, "estimated_amount": 8799, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6159.37, "standard_charge_percentage": 70.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3183.46, "estimated_amount": 3183, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3441.58, "estimated_amount": 3441, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 60.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2639.73, "standard_charge_percentage": 30.0000, "estimated_amount": 2639, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6159.37, "standard_charge_percentage": 70.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4927.5, "standard_charge_percentage": 56.0000, "estimated_amount": 4927, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8623.12, "standard_charge_percentage": 98.0000, "estimated_amount": 8623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1755.21, "estimated_amount": 1755, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 590.76, "estimated_amount": 590, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2261.1, "estimated_amount": 2261, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4399.55, "standard_charge_percentage": 50.0000, "estimated_amount": 4399, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7699.21, "standard_charge_percentage": 87.5000, "estimated_amount": 7699, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8799.1, "standard_charge_percentage": 100.0000, "estimated_amount": 8799, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7215.26, "standard_charge_percentage": 82.0000, "estimated_amount": 7215, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5103.48, "standard_charge_percentage": 58.0000, "estimated_amount": 5103, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 60.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6093.09, "estimated_amount": 6093, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2323.07, "estimated_amount": 2323, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" }]}]} , { "description": "Tis trnfr f/c/c/m/n/a/g/h/f", "code_information": [ { "code": "14040", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7371.71, "discounted_cash": 2237,"minimum": 590.76,"maximum": 7371.71,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7003.12, "standard_charge_percentage": 95.0000, "estimated_amount": 7003, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4423.03, "standard_charge_percentage": 60.0000, "estimated_amount": 4423, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5160.2, "standard_charge_percentage": 70.0000, "estimated_amount": 5160, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6044.8, "standard_charge_percentage": 82.0000, "estimated_amount": 6044, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4275.59, "standard_charge_percentage": 58.0000, "estimated_amount": 4275, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1755.21, "estimated_amount": 1755, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3183.46, "estimated_amount": 3183, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2245.51, "estimated_amount": 2245, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1730.35, "estimated_amount": 1730, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2229.91, "estimated_amount": 2229, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6265.95, "standard_charge_percentage": 85.0000, "estimated_amount": 6265, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2211.51, "standard_charge_percentage": 30.0000, "estimated_amount": 2211, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5160.2, "standard_charge_percentage": 70.0000, "estimated_amount": 5160, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5160.2, "standard_charge_percentage": 70.0000, "estimated_amount": 5160, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7224.28, "standard_charge_percentage": 98.0000, "estimated_amount": 7224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 590.76, "estimated_amount": 590, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2261.1, "estimated_amount": 2261, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6450.25, "standard_charge_percentage": 87.5000, "estimated_amount": 6450, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7371.71, "standard_charge_percentage": 100.0000, "estimated_amount": 7371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6093.09, "estimated_amount": 6093, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2323.07, "estimated_amount": 2323, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3441.58, "estimated_amount": 3441, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3685.86, "standard_charge_percentage": 50.0000, "estimated_amount": 3685, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2948.68, "standard_charge_percentage": 40.0000, "estimated_amount": 2948, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6450.25, "standard_charge_percentage": 87.5000, "estimated_amount": 6450, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7371.71, "standard_charge_percentage": 100.0000, "estimated_amount": 7371, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4128.16, "standard_charge_percentage": 56.0000, "estimated_amount": 4128, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4423.03, "standard_charge_percentage": 60.0000, "estimated_amount": 4423, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" }]}]} , { "description": "I&D COMPLEX WOUND INFEC POSTOP", "code_information": [ { "code": "15271", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8683.24, "discounted_cash": 2237,"minimum": 153.99,"maximum": 8683.24,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1730.35, "estimated_amount": 1730, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6078.27, "standard_charge_percentage": 70.0000, "estimated_amount": 6078, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6512.43, "standard_charge_percentage": 75.0000, "estimated_amount": 6512, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4862.61, "standard_charge_percentage": 56.0000, "estimated_amount": 4862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5036.28, "standard_charge_percentage": 58.0000, "estimated_amount": 5036, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3212.8, "standard_charge_percentage": 37.0000, "estimated_amount": 3212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7814.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7814, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6512.43, "standard_charge_percentage": 75.0000, "estimated_amount": 6512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5209.94, "standard_charge_percentage": 60.0000, "estimated_amount": 5209, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1755.21, "estimated_amount": 1755, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3441.58, "estimated_amount": 3441, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2261.1, "estimated_amount": 2261, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6512.43, "standard_charge_percentage": 75.0000, "estimated_amount": 6512, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6512.43, "standard_charge_percentage": 75.0000, "estimated_amount": 6512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7814.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7814, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7814.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7814, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3473.3, "standard_charge_percentage": 40.0000, "estimated_amount": 3473, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7597.84, "standard_charge_percentage": 87.5000, "estimated_amount": 7597, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8683.24, "standard_charge_percentage": 100.0000, "estimated_amount": 8683, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2604.97, "standard_charge_percentage": 30.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6512.43, "standard_charge_percentage": 75.0000, "estimated_amount": 6512, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6078.27, "standard_charge_percentage": 70.0000, "estimated_amount": 6078, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6078.27, "standard_charge_percentage": 70.0000, "estimated_amount": 6078, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7814.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2229.91, "estimated_amount": 2229, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7814.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7814, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7380.75, "standard_charge_percentage": 85.0000, "estimated_amount": 7380, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8683.24, "standard_charge_percentage": 100.0000, "estimated_amount": 8683, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8509.58, "standard_charge_percentage": 98.0000, "estimated_amount": 8509, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6093.09, "estimated_amount": 6093, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2323.07, "estimated_amount": 2323, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3183.46, "estimated_amount": 3183, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2245.51, "estimated_amount": 2245, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 153.99, "estimated_amount": 153, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4341.62, "standard_charge_percentage": 50.0000, "estimated_amount": 4341, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7597.84, "standard_charge_percentage": 87.5000, "estimated_amount": 7597, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8249.08, "standard_charge_percentage": 95.0000, "estimated_amount": 8249, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5209.94, "standard_charge_percentage": 60.0000, "estimated_amount": 5209, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7120.26, "standard_charge_percentage": 82.0000, "estimated_amount": 7120, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" }]}]} , { "description": "D-19 BIOPSY SKIN LESION", "code_information": [ { "code": "15272", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1547.79,"minimum": 56.48,"maximum": 1547.79,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1160.84, "standard_charge_percentage": 75.0000, "estimated_amount": 1160, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1315.62, "standard_charge_percentage": 85.0000, "estimated_amount": 1315, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1238.23, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1238.23, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1547.79, "standard_charge_percentage": 100.0000, "estimated_amount": 1547, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 928.67, "standard_charge_percentage": 60.0000, "estimated_amount": 928, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1238.23, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1083.45, "standard_charge_percentage": 70.0000, "estimated_amount": 1083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1547.79, "estimated_amount": 1547, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1393.01, "standard_charge_percentage": 90.0000, "estimated_amount": 1393, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 619.12, "standard_charge_percentage": 40.0000, "estimated_amount": 619, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1238.23, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1238.23, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1160.84, "standard_charge_percentage": 75.0000, "estimated_amount": 1160, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1393.01, "standard_charge_percentage": 90.0000, "estimated_amount": 1393, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1160.84, "standard_charge_percentage": 75.0000, "estimated_amount": 1160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 928.67, "standard_charge_percentage": 60.0000, "estimated_amount": 928, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1238.23, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1238.23, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1393.01, "standard_charge_percentage": 90.0000, "estimated_amount": 1393, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1470.4, "standard_charge_percentage": 95.0000, "estimated_amount": 1470, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1547.79, "standard_charge_percentage": 100.0000, "estimated_amount": 1547, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 464.34, "standard_charge_percentage": 30.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1083.45, "standard_charge_percentage": 70.0000, "estimated_amount": 1083, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1083.45, "standard_charge_percentage": 70.0000, "estimated_amount": 1083, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1269.19, "standard_charge_percentage": 82.0000, "estimated_amount": 1269, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 572.68, "standard_charge_percentage": 37.0000, "estimated_amount": 572, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1238.23, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1393.01, "standard_charge_percentage": 90.0000, "estimated_amount": 1393, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 56.48, "estimated_amount": 56, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1160.84, "standard_charge_percentage": 75.0000, "estimated_amount": 1160, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 773.89, "standard_charge_percentage": 50.0000, "estimated_amount": 773, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1393.01, "standard_charge_percentage": 90.0000, "estimated_amount": 1393, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1354.32, "standard_charge_percentage": 87.5000, "estimated_amount": 1354, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1354.32, "standard_charge_percentage": 87.5000, "estimated_amount": 1354, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1238.23, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1238.23, "standard_charge_percentage": 80.0000, "estimated_amount": 1238, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1160.84, "standard_charge_percentage": 75.0000, "estimated_amount": 1160, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 866.76, "standard_charge_percentage": 56.0000, "estimated_amount": 866, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 897.72, "standard_charge_percentage": 58.0000, "estimated_amount": 897, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1516.83, "standard_charge_percentage": 98.0000, "estimated_amount": 1516, "methodology": "percent of total billed charges" }]}]} , { "description": "BIOPSY, THYROID", "code_information": [ { "code": "15275", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8683.24, "discounted_cash": 2237,"minimum": 153.99,"maximum": 8683.24,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7380.75, "standard_charge_percentage": 85.0000, "estimated_amount": 7380, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7597.84, "standard_charge_percentage": 87.5000, "estimated_amount": 7597, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8683.24, "standard_charge_percentage": 100.0000, "estimated_amount": 8683, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8683.24, "standard_charge_percentage": 100.0000, "estimated_amount": 8683, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5209.94, "standard_charge_percentage": 60.0000, "estimated_amount": 5209, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6078.27, "standard_charge_percentage": 70.0000, "estimated_amount": 6078, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6078.27, "standard_charge_percentage": 70.0000, "estimated_amount": 6078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2245.51, "estimated_amount": 2245, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1730.35, "estimated_amount": 1730, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2229.91, "estimated_amount": 2229, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4341.62, "standard_charge_percentage": 50.0000, "estimated_amount": 4341, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7814.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7814, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8249.08, "standard_charge_percentage": 95.0000, "estimated_amount": 8249, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6512.43, "standard_charge_percentage": 75.0000, "estimated_amount": 6512, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4862.61, "standard_charge_percentage": 56.0000, "estimated_amount": 4862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1755.21, "estimated_amount": 1755, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3441.58, "estimated_amount": 3441, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 153.99, "estimated_amount": 153, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6512.43, "standard_charge_percentage": 75.0000, "estimated_amount": 6512, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6512.43, "standard_charge_percentage": 75.0000, "estimated_amount": 6512, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7814.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7814, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7814.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7814, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7597.84, "standard_charge_percentage": 87.5000, "estimated_amount": 7597, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6512.43, "standard_charge_percentage": 75.0000, "estimated_amount": 6512, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6078.27, "standard_charge_percentage": 70.0000, "estimated_amount": 6078, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7120.26, "standard_charge_percentage": 82.0000, "estimated_amount": 7120, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5036.28, "standard_charge_percentage": 58.0000, "estimated_amount": 5036, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7814.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7814, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7814.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7814, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2261.1, "estimated_amount": 2261, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3473.3, "standard_charge_percentage": 40.0000, "estimated_amount": 3473, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6946.59, "standard_charge_percentage": 80.0000, "estimated_amount": 6946, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2604.97, "standard_charge_percentage": 30.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3212.8, "standard_charge_percentage": 37.0000, "estimated_amount": 3212, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8509.58, "standard_charge_percentage": 98.0000, "estimated_amount": 8509, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6512.43, "standard_charge_percentage": 75.0000, "estimated_amount": 6512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5209.94, "standard_charge_percentage": 60.0000, "estimated_amount": 5209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6093.09, "estimated_amount": 6093, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2323.07, "estimated_amount": 2323, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3183.46, "estimated_amount": 3183, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "15276", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1021,"minimum": 56.48,"maximum": 1021,"payers_information":[{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 893.38, "standard_charge_percentage": 87.5000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1021, "standard_charge_percentage": 100.0000, "estimated_amount": 1021, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1021, "standard_charge_percentage": 100.0000, "estimated_amount": 1021, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 306.3, "standard_charge_percentage": 30.0000, "estimated_amount": 306, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 765.75, "standard_charge_percentage": 75.0000, "estimated_amount": 765, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 765.75, "standard_charge_percentage": 75.0000, "estimated_amount": 765, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 377.77, "standard_charge_percentage": 37.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 918.9, "standard_charge_percentage": 90.0000, "estimated_amount": 918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 56.48, "estimated_amount": 56, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 816.8, "standard_charge_percentage": 80.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 816.8, "standard_charge_percentage": 80.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 918.9, "standard_charge_percentage": 90.0000, "estimated_amount": 918, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 408.4, "standard_charge_percentage": 40.0000, "estimated_amount": 408, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 893.38, "standard_charge_percentage": 87.5000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 816.8, "standard_charge_percentage": 80.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 816.8, "standard_charge_percentage": 80.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 714.7, "standard_charge_percentage": 70.0000, "estimated_amount": 714, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 714.7, "standard_charge_percentage": 70.0000, "estimated_amount": 714, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 837.22, "standard_charge_percentage": 82.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 571.76, "standard_charge_percentage": 56.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 816.8, "standard_charge_percentage": 80.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 918.9, "standard_charge_percentage": 90.0000, "estimated_amount": 918, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1000.58, "standard_charge_percentage": 98.0000, "estimated_amount": 1000, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 765.75, "standard_charge_percentage": 75.0000, "estimated_amount": 765, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 765.75, "standard_charge_percentage": 75.0000, "estimated_amount": 765, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 510.5, "standard_charge_percentage": 50.0000, "estimated_amount": 510, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 867.85, "standard_charge_percentage": 85.0000, "estimated_amount": 867, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 969.95, "standard_charge_percentage": 95.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 816.8, "standard_charge_percentage": 80.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1021, "estimated_amount": 1021, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 765.75, "standard_charge_percentage": 75.0000, "estimated_amount": 765, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 918.9, "standard_charge_percentage": 90.0000, "estimated_amount": 918, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 918.9, "standard_charge_percentage": 90.0000, "estimated_amount": 918, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 816.8, "standard_charge_percentage": 80.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 816.8, "standard_charge_percentage": 80.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 612.6, "standard_charge_percentage": 60.0000, "estimated_amount": 612, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 816.8, "standard_charge_percentage": 80.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 816.8, "standard_charge_percentage": 80.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 714.7, "standard_charge_percentage": 70.0000, "estimated_amount": 714, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 592.18, "standard_charge_percentage": 58.0000, "estimated_amount": 592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 612.6, "standard_charge_percentage": 60.0000, "estimated_amount": 612, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "15734", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 12539.8, "discounted_cash": 4477,"minimum": 1123,"maximum": 12539.8,"payers_information":[{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 9404.87, "standard_charge_percentage": 75.0000, "estimated_amount": 9404, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 10658.9, "standard_charge_percentage": 85.0000, "estimated_amount": 10658, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 12539.8, "standard_charge_percentage": 100.0000, "estimated_amount": 12539, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 8777.88, "standard_charge_percentage": 70.0000, "estimated_amount": 8777, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 11285.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11285, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 12194.5, "estimated_amount": 12194, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3443.94, "estimated_amount": 3443, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 5510.3, "estimated_amount": 5510, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 6371.29, "estimated_amount": 6371, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6887.88, "estimated_amount": 6887, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4494.11, "estimated_amount": 4494, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 3120.91, "estimated_amount": 3120, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1162.21, "estimated_amount": 1162, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 9404.87, "standard_charge_percentage": 75.0000, "estimated_amount": 9404, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 11285.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11285, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 10972.4, "standard_charge_percentage": 87.5000, "estimated_amount": 10972, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 10031.9, "standard_charge_percentage": 80.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 12539.8, "standard_charge_percentage": 100.0000, "estimated_amount": 12539, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 8777.88, "standard_charge_percentage": 70.0000, "estimated_amount": 8777, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 7022.3, "standard_charge_percentage": 56.0000, "estimated_amount": 7022, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3443.94, "estimated_amount": 3443, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3512.82, "estimated_amount": 3512, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3443.94, "estimated_amount": 3443, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4649.32, "estimated_amount": 4649, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3616.14, "estimated_amount": 3616, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3443.94, "estimated_amount": 3443, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 3261.49, "estimated_amount": 3261, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4525.32, "estimated_amount": 4525, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4462.9, "estimated_amount": 4462, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 10031.9, "standard_charge_percentage": 80.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6269.91, "standard_charge_percentage": 50.0000, "estimated_amount": 6269, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 11285.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11285, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 10031.9, "standard_charge_percentage": 80.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 11912.8, "standard_charge_percentage": 95.0000, "estimated_amount": 11912, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 7523.9, "standard_charge_percentage": 60.0000, "estimated_amount": 7523, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 10031.9, "standard_charge_percentage": 80.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 10031.9, "standard_charge_percentage": 80.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 7273.1, "standard_charge_percentage": 58.0000, "estimated_amount": 7273, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 10031.9, "standard_charge_percentage": 80.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 7523.9, "standard_charge_percentage": 60.0000, "estimated_amount": 7523, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3443.94, "estimated_amount": 3443, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4821.52, "estimated_amount": 4821, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3443.94, "estimated_amount": 3443, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3443.94, "estimated_amount": 3443, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 3120.91, "estimated_amount": 3120, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 10031.9, "standard_charge_percentage": 80.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 11285.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11285, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5015.93, "standard_charge_percentage": 40.0000, "estimated_amount": 5015, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 10972.4, "standard_charge_percentage": 87.5000, "estimated_amount": 10972, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 10031.9, "standard_charge_percentage": 80.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 10031.9, "standard_charge_percentage": 80.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 10031.9, "standard_charge_percentage": 80.0000, "estimated_amount": 10031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3761.95, "standard_charge_percentage": 30.0000, "estimated_amount": 3761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 9404.87, "standard_charge_percentage": 75.0000, "estimated_amount": 9404, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 8777.88, "standard_charge_percentage": 70.0000, "estimated_amount": 8777, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 9404.87, "standard_charge_percentage": 75.0000, "estimated_amount": 9404, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 10282.7, "standard_charge_percentage": 82.0000, "estimated_amount": 10282, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 11285.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11285, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 12289, "standard_charge_percentage": 98.0000, "estimated_amount": 12289, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 9404.87, "standard_charge_percentage": 75.0000, "estimated_amount": 9404, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3443.94, "estimated_amount": 3443, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3443.94, "estimated_amount": 3443, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3443.94, "estimated_amount": 3443, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3616.14, "estimated_amount": 3616, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4821.52, "estimated_amount": 4821, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 5510.3, "estimated_amount": 5510, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "15851", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7250.78, "discounted_cash": 2237,"minimum": 590.76,"maximum": 7250.78,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 590.76, "estimated_amount": 590, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2261.1, "estimated_amount": 2261, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5438.09, "standard_charge_percentage": 75.0000, "estimated_amount": 5438, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6525.7, "standard_charge_percentage": 90.0000, "estimated_amount": 6525, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6163.16, "standard_charge_percentage": 85.0000, "estimated_amount": 6163, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6344.43, "standard_charge_percentage": 87.5000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5800.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5800, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4350.47, "standard_charge_percentage": 60.0000, "estimated_amount": 4350, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5438.09, "standard_charge_percentage": 75.0000, "estimated_amount": 5438, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5075.55, "standard_charge_percentage": 70.0000, "estimated_amount": 5075, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5075.55, "standard_charge_percentage": 70.0000, "estimated_amount": 5075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5800.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5800, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6093.09, "estimated_amount": 6093, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3441.58, "estimated_amount": 3441, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5800.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5800, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6344.43, "standard_charge_percentage": 87.5000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5800.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5800, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5800.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5800, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7250.78, "standard_charge_percentage": 100.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7250.78, "standard_charge_percentage": 100.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2175.23, "standard_charge_percentage": 30.0000, "estimated_amount": 2175, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5075.55, "standard_charge_percentage": 70.0000, "estimated_amount": 5075, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6525.7, "standard_charge_percentage": 90.0000, "estimated_amount": 6525, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2229.91, "estimated_amount": 2229, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5438.09, "standard_charge_percentage": 75.0000, "estimated_amount": 5438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5800.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5800, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3625.39, "standard_charge_percentage": 50.0000, "estimated_amount": 3625, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6525.7, "standard_charge_percentage": 90.0000, "estimated_amount": 6525, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5800.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5800, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5800.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5800, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5438.09, "standard_charge_percentage": 75.0000, "estimated_amount": 5438, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4205.45, "standard_charge_percentage": 58.0000, "estimated_amount": 4205, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7105.76, "standard_charge_percentage": 98.0000, "estimated_amount": 7105, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1755.21, "estimated_amount": 1755, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2245.51, "estimated_amount": 2245, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1730.35, "estimated_amount": 1730, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6525.7, "standard_charge_percentage": 90.0000, "estimated_amount": 6525, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2900.31, "standard_charge_percentage": 40.0000, "estimated_amount": 2900, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 6888.24, "standard_charge_percentage": 95.0000, "estimated_amount": 6888, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5800.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5800, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5800.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5800, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 5945.64, "standard_charge_percentage": 82.0000, "estimated_amount": 5945, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4060.44, "standard_charge_percentage": 56.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2682.79, "standard_charge_percentage": 37.0000, "estimated_amount": 2682, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6525.7, "standard_charge_percentage": 90.0000, "estimated_amount": 6525, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5438.09, "standard_charge_percentage": 75.0000, "estimated_amount": 5438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4350.47, "standard_charge_percentage": 60.0000, "estimated_amount": 4350, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2323.07, "estimated_amount": 2323, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3183.46, "estimated_amount": 3183, "methodology": "fee schedule" }]}]} , { "description": "Hc Treat Burn 1St Degree, Initial", "code_information": [ { "code": "16000", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1002.04, "discounted_cash": 242,"minimum": 169.39,"maximum": 1002.04,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 982, "standard_charge_percentage": 98.0000, "estimated_amount": 982, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 851.73, "standard_charge_percentage": 85.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 581.18, "standard_charge_percentage": 58.0000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 951.94, "standard_charge_percentage": 95.0000, "estimated_amount": 951, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 561.14, "standard_charge_percentage": 56.0000, "estimated_amount": 561, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 400.82, "standard_charge_percentage": 40.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 300.61, "standard_charge_percentage": 30.0000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 821.67, "standard_charge_percentage": 82.0000, "estimated_amount": 821, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 370.75, "standard_charge_percentage": 37.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" }]}]} , { "description": "Hc Dress/Debride Burn <5% Total Sm", "code_information": [ { "code": "16020", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 931.67, "discounted_cash": 242,"minimum": 169.39,"maximum": 931.67,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 189.79, "estimated_amount": 189, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 815.21, "standard_charge_percentage": 87.5000, "estimated_amount": 815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 885.09, "standard_charge_percentage": 95.0000, "estimated_amount": 885, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 931.67, "standard_charge_percentage": 100.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 763.97, "standard_charge_percentage": 82.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 559, "standard_charge_percentage": 60.0000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 791.92, "standard_charge_percentage": 85.0000, "estimated_amount": 791, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 815.21, "standard_charge_percentage": 87.5000, "estimated_amount": 815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 931.67, "standard_charge_percentage": 100.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 559, "standard_charge_percentage": 60.0000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 279.5, "standard_charge_percentage": 30.0000, "estimated_amount": 279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 540.37, "standard_charge_percentage": 58.0000, "estimated_amount": 540, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 344.72, "standard_charge_percentage": 37.0000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 931.67, "estimated_amount": 931, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 372.67, "standard_charge_percentage": 40.0000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 465.83, "standard_charge_percentage": 50.0000, "estimated_amount": 465, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 521.74, "standard_charge_percentage": 56.0000, "estimated_amount": 521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 913.04, "standard_charge_percentage": 98.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" }]}]} , { "description": "Hc Dress/Debride Burn 5-10% Ttl Med", "code_information": [ { "code": "16025", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 957.89, "discounted_cash": 242,"minimum": 169.39,"maximum": 957.89,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 718.42, "standard_charge_percentage": 75.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 862.1, "standard_charge_percentage": 90.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 574.73, "standard_charge_percentage": 60.0000, "estimated_amount": 574, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 718.42, "standard_charge_percentage": 75.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 957.89, "estimated_amount": 957, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 478.94, "standard_charge_percentage": 50.0000, "estimated_amount": 478, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 862.1, "standard_charge_percentage": 90.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 814.21, "standard_charge_percentage": 85.0000, "estimated_amount": 814, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 383.16, "standard_charge_percentage": 40.0000, "estimated_amount": 383, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 957.89, "standard_charge_percentage": 100.0000, "estimated_amount": 957, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 718.42, "standard_charge_percentage": 75.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 785.47, "standard_charge_percentage": 82.0000, "estimated_amount": 785, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 862.1, "standard_charge_percentage": 90.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 574.73, "standard_charge_percentage": 60.0000, "estimated_amount": 574, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 862.1, "standard_charge_percentage": 90.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 838.15, "standard_charge_percentage": 87.5000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 838.15, "standard_charge_percentage": 87.5000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 910, "standard_charge_percentage": 95.0000, "estimated_amount": 910, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 957.89, "standard_charge_percentage": 100.0000, "estimated_amount": 957, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 287.37, "standard_charge_percentage": 30.0000, "estimated_amount": 287, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 670.52, "standard_charge_percentage": 70.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 354.42, "standard_charge_percentage": 37.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 938.73, "standard_charge_percentage": 98.0000, "estimated_amount": 938, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 189.79, "estimated_amount": 189, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 718.42, "standard_charge_percentage": 75.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 766.31, "standard_charge_percentage": 80.0000, "estimated_amount": 766, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 670.52, "standard_charge_percentage": 70.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 670.52, "standard_charge_percentage": 70.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 718.42, "standard_charge_percentage": 75.0000, "estimated_amount": 718, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 536.42, "standard_charge_percentage": 56.0000, "estimated_amount": 536, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 555.58, "standard_charge_percentage": 58.0000, "estimated_amount": 555, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 862.1, "standard_charge_percentage": 90.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" }]}]} , { "description": "Hc Chem Cautery Granulatn Tissue", "code_information": [ { "code": "17250", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 931.67, "discounted_cash": 242,"minimum": 85.8,"maximum": 931.67,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 815.21, "standard_charge_percentage": 87.5000, "estimated_amount": 815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 279.5, "standard_charge_percentage": 30.0000, "estimated_amount": 279, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 344.72, "standard_charge_percentage": 37.0000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 372.67, "standard_charge_percentage": 40.0000, "estimated_amount": 372, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 815.21, "standard_charge_percentage": 87.5000, "estimated_amount": 815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 885.09, "standard_charge_percentage": 95.0000, "estimated_amount": 885, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 931.67, "standard_charge_percentage": 100.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 652.17, "standard_charge_percentage": 70.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 521.74, "standard_charge_percentage": 56.0000, "estimated_amount": 521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 559, "standard_charge_percentage": 60.0000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 85.8, "estimated_amount": 85, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 465.83, "standard_charge_percentage": 50.0000, "estimated_amount": 465, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 791.92, "standard_charge_percentage": 85.0000, "estimated_amount": 791, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 559, "standard_charge_percentage": 60.0000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 540.37, "standard_charge_percentage": 58.0000, "estimated_amount": 540, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 913.04, "standard_charge_percentage": 98.0000, "estimated_amount": 913, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 931.67, "estimated_amount": 931, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 698.75, "standard_charge_percentage": 75.0000, "estimated_amount": 698, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 838.5, "standard_charge_percentage": 90.0000, "estimated_amount": 838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 931.67, "standard_charge_percentage": 100.0000, "estimated_amount": 931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 745.34, "standard_charge_percentage": 80.0000, "estimated_amount": 745, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 763.97, "standard_charge_percentage": 82.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" }]}]} , { "description": "Hc I&D Breast Lesion", "code_information": [ { "code": "19000", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3472.36, "discounted_cash": 860,"minimum": 257.4,"maximum": 3472.36,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2604.27, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3125.12, "standard_charge_percentage": 90.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2951.51, "standard_charge_percentage": 85.0000, "estimated_amount": 2951, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3298.74, "standard_charge_percentage": 95.0000, "estimated_amount": 3298, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3472.36, "standard_charge_percentage": 100.0000, "estimated_amount": 3472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1041.71, "standard_charge_percentage": 30.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2604.27, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2847.34, "standard_charge_percentage": 82.0000, "estimated_amount": 2847, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1284.77, "standard_charge_percentage": 37.0000, "estimated_amount": 1284, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3125.12, "standard_charge_percentage": 90.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3402.91, "standard_charge_percentage": 98.0000, "estimated_amount": 3402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2083.42, "standard_charge_percentage": 60.0000, "estimated_amount": 2083, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1224.48, "estimated_amount": 1224, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1323.76, "estimated_amount": 1323, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 857.71, "estimated_amount": 857, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2604.27, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1388.94, "standard_charge_percentage": 40.0000, "estimated_amount": 1388, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3038.32, "standard_charge_percentage": 87.5000, "estimated_amount": 3038, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3472.36, "standard_charge_percentage": 100.0000, "estimated_amount": 3472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3125.12, "standard_charge_percentage": 90.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 863.71, "estimated_amount": 863, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 257.4, "estimated_amount": 257, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1736.18, "standard_charge_percentage": 50.0000, "estimated_amount": 1736, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3125.12, "standard_charge_percentage": 90.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2083.42, "standard_charge_percentage": 60.0000, "estimated_amount": 2083, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2777.89, "standard_charge_percentage": 80.0000, "estimated_amount": 2777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2604.27, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2430.65, "standard_charge_percentage": 70.0000, "estimated_amount": 2430, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2430.65, "standard_charge_percentage": 70.0000, "estimated_amount": 2430, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1944.52, "standard_charge_percentage": 56.0000, "estimated_amount": 1944, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2013.97, "standard_charge_percentage": 58.0000, "estimated_amount": 2013, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2604.27, "standard_charge_percentage": 75.0000, "estimated_amount": 2604, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2343.63, "estimated_amount": 2343, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 650.66, "estimated_amount": 650, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 869.71, "estimated_amount": 869, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3125.12, "standard_charge_percentage": 90.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3038.32, "standard_charge_percentage": 87.5000, "estimated_amount": 3038, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2430.65, "standard_charge_percentage": 70.0000, "estimated_amount": 2430, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 675.12, "estimated_amount": 675, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 893.54, "estimated_amount": 893, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" }]}]} , { "description": "Hc Bx Breast W Device Stereotact Guide 1St Lesion", "code_information": [ { "code": "19081", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5856.15, "discounted_cash": 1981,"minimum": 474.6,"maximum": 5856.15,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4684.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4684, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2928.07, "standard_charge_percentage": 50.0000, "estimated_amount": 2928, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5270.53, "standard_charge_percentage": 90.0000, "estimated_amount": 5270, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5856.15, "standard_charge_percentage": 100.0000, "estimated_amount": 5856, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4684.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4684, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4684.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4684, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4684.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4684, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1756.85, "standard_charge_percentage": 30.0000, "estimated_amount": 1756, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4099.31, "standard_charge_percentage": 70.0000, "estimated_amount": 4099, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4099.31, "standard_charge_percentage": 70.0000, "estimated_amount": 4099, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2166.78, "standard_charge_percentage": 37.0000, "estimated_amount": 2166, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4684.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4684, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5270.53, "standard_charge_percentage": 90.0000, "estimated_amount": 5270, "methodology": "percent of total billed charges" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4392.11, "standard_charge_percentage": 75.0000, "estimated_amount": 4392, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4392.11, "standard_charge_percentage": 75.0000, "estimated_amount": 4392, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5270.53, "standard_charge_percentage": 90.0000, "estimated_amount": 5270, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2342.46, "standard_charge_percentage": 40.0000, "estimated_amount": 2342, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5856.15, "standard_charge_percentage": 100.0000, "estimated_amount": 5856, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4684.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4684, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3279.44, "standard_charge_percentage": 56.0000, "estimated_amount": 3279, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5739.03, "standard_charge_percentage": 98.0000, "estimated_amount": 5739, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 474.6, "estimated_amount": 474, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4684.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4684, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5270.53, "standard_charge_percentage": 90.0000, "estimated_amount": 5270, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4977.73, "standard_charge_percentage": 85.0000, "estimated_amount": 4977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5124.13, "standard_charge_percentage": 87.5000, "estimated_amount": 5124, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4684.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4684, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4684.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4684, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4684.92, "standard_charge_percentage": 80.0000, "estimated_amount": 4684, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5563.34, "standard_charge_percentage": 95.0000, "estimated_amount": 5563, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3513.69, "standard_charge_percentage": 60.0000, "estimated_amount": 3513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4392.11, "standard_charge_percentage": 75.0000, "estimated_amount": 4392, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4099.31, "standard_charge_percentage": 70.0000, "estimated_amount": 4099, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4802.04, "standard_charge_percentage": 82.0000, "estimated_amount": 4802, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3396.57, "standard_charge_percentage": 58.0000, "estimated_amount": 3396, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 474.6, "estimated_amount": 474, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5124.13, "standard_charge_percentage": 87.5000, "estimated_amount": 5124, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4392.11, "standard_charge_percentage": 75.0000, "estimated_amount": 4392, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5270.53, "standard_charge_percentage": 90.0000, "estimated_amount": 5270, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4392.11, "standard_charge_percentage": 75.0000, "estimated_amount": 4392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3513.69, "standard_charge_percentage": 60.0000, "estimated_amount": 3513, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "Hc Bx Breast W Device Stereotact Guide Addl Lesion", "code_information": [ { "code": "19082", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4844.06,"minimum": 42.71,"maximum": 4844.06,"payers_information":[{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2422.03, "standard_charge_percentage": 50.0000, "estimated_amount": 2422, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 4238.55, "standard_charge_percentage": 87.5000, "estimated_amount": 4238, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2906.44, "standard_charge_percentage": 60.0000, "estimated_amount": 2906, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3875.25, "standard_charge_percentage": 80.0000, "estimated_amount": 3875, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3390.84, "standard_charge_percentage": 70.0000, "estimated_amount": 3390, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3972.13, "standard_charge_percentage": 82.0000, "estimated_amount": 3972, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2712.67, "standard_charge_percentage": 56.0000, "estimated_amount": 2712, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 42.71, "estimated_amount": 42, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3875.25, "standard_charge_percentage": 80.0000, "estimated_amount": 3875, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3633.05, "standard_charge_percentage": 75.0000, "estimated_amount": 3633, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 4359.65, "standard_charge_percentage": 90.0000, "estimated_amount": 4359, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 4359.65, "standard_charge_percentage": 90.0000, "estimated_amount": 4359, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4117.45, "standard_charge_percentage": 85.0000, "estimated_amount": 4117, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3875.25, "standard_charge_percentage": 80.0000, "estimated_amount": 3875, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 4844.06, "standard_charge_percentage": 100.0000, "estimated_amount": 4844, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 4844.06, "standard_charge_percentage": 100.0000, "estimated_amount": 4844, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3875.25, "standard_charge_percentage": 80.0000, "estimated_amount": 3875, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 4359.65, "standard_charge_percentage": 90.0000, "estimated_amount": 4359, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3633.05, "standard_charge_percentage": 75.0000, "estimated_amount": 3633, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3875.25, "standard_charge_percentage": 80.0000, "estimated_amount": 3875, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 4359.65, "standard_charge_percentage": 90.0000, "estimated_amount": 4359, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1937.62, "standard_charge_percentage": 40.0000, "estimated_amount": 1937, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3875.25, "standard_charge_percentage": 80.0000, "estimated_amount": 3875, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 4601.86, "standard_charge_percentage": 95.0000, "estimated_amount": 4601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3875.25, "standard_charge_percentage": 80.0000, "estimated_amount": 3875, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3875.25, "standard_charge_percentage": 80.0000, "estimated_amount": 3875, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1453.22, "standard_charge_percentage": 30.0000, "estimated_amount": 1453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3633.05, "standard_charge_percentage": 75.0000, "estimated_amount": 3633, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3390.84, "standard_charge_percentage": 70.0000, "estimated_amount": 3390, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2809.55, "standard_charge_percentage": 58.0000, "estimated_amount": 2809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3633.05, "standard_charge_percentage": 75.0000, "estimated_amount": 3633, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 4238.55, "standard_charge_percentage": 87.5000, "estimated_amount": 4238, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3875.25, "standard_charge_percentage": 80.0000, "estimated_amount": 3875, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3390.84, "standard_charge_percentage": 70.0000, "estimated_amount": 3390, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3633.05, "standard_charge_percentage": 75.0000, "estimated_amount": 3633, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1792.3, "standard_charge_percentage": 37.0000, "estimated_amount": 1792, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3875.25, "standard_charge_percentage": 80.0000, "estimated_amount": 3875, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 4359.65, "standard_charge_percentage": 90.0000, "estimated_amount": 4359, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 4747.18, "standard_charge_percentage": 98.0000, "estimated_amount": 4747, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2906.44, "standard_charge_percentage": 60.0000, "estimated_amount": 2906, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Bx Breast W Device Us Guide 1St Lesion", "code_information": [ { "code": "19083", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7520.97, "discounted_cash": 1981,"minimum": 474.6,"maximum": 7520.97,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6392.82, "standard_charge_percentage": 85.0000, "estimated_amount": 6392, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3008.39, "standard_charge_percentage": 40.0000, "estimated_amount": 3008, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7144.92, "standard_charge_percentage": 95.0000, "estimated_amount": 7144, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7520.97, "standard_charge_percentage": 100.0000, "estimated_amount": 7520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6580.85, "standard_charge_percentage": 87.5000, "estimated_amount": 6580, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2256.29, "standard_charge_percentage": 30.0000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4362.16, "standard_charge_percentage": 58.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6580.85, "standard_charge_percentage": 87.5000, "estimated_amount": 6580, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4512.58, "standard_charge_percentage": 60.0000, "estimated_amount": 4512, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4211.74, "standard_charge_percentage": 56.0000, "estimated_amount": 4211, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2782.76, "standard_charge_percentage": 37.0000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7370.55, "standard_charge_percentage": 98.0000, "estimated_amount": 7370, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4512.58, "standard_charge_percentage": 60.0000, "estimated_amount": 4512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 474.6, "estimated_amount": 474, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 474.6, "estimated_amount": 474, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3760.49, "standard_charge_percentage": 50.0000, "estimated_amount": 3760, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7520.97, "standard_charge_percentage": 100.0000, "estimated_amount": 7520, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6167.2, "standard_charge_percentage": 82.0000, "estimated_amount": 6167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "US TESTICLE SONO", "code_information": [ { "code": "19084", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1459.45,"minimum": 40.14,"maximum": 1459.45,"payers_information":[{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1459.45, "standard_charge_percentage": 100.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1167.56, "standard_charge_percentage": 80.0000, "estimated_amount": 1167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1094.59, "standard_charge_percentage": 75.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1021.62, "standard_charge_percentage": 70.0000, "estimated_amount": 1021, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1021.62, "standard_charge_percentage": 70.0000, "estimated_amount": 1021, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1094.59, "standard_charge_percentage": 75.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1167.56, "standard_charge_percentage": 80.0000, "estimated_amount": 1167, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1430.26, "standard_charge_percentage": 98.0000, "estimated_amount": 1430, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 40.14, "estimated_amount": 40, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1167.56, "standard_charge_percentage": 80.0000, "estimated_amount": 1167, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1313.51, "standard_charge_percentage": 90.0000, "estimated_amount": 1313, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1277.02, "standard_charge_percentage": 87.5000, "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1167.56, "standard_charge_percentage": 80.0000, "estimated_amount": 1167, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1459.45, "standard_charge_percentage": 100.0000, "estimated_amount": 1459, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 875.67, "standard_charge_percentage": 60.0000, "estimated_amount": 875, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 817.29, "standard_charge_percentage": 56.0000, "estimated_amount": 817, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 846.48, "standard_charge_percentage": 58.0000, "estimated_amount": 846, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1459.45, "estimated_amount": 1459, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1094.59, "standard_charge_percentage": 75.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1167.56, "standard_charge_percentage": 80.0000, "estimated_amount": 1167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 729.73, "standard_charge_percentage": 50.0000, "estimated_amount": 729, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1313.51, "standard_charge_percentage": 90.0000, "estimated_amount": 1313, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1240.53, "standard_charge_percentage": 85.0000, "estimated_amount": 1240, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1277.02, "standard_charge_percentage": 87.5000, "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1167.56, "standard_charge_percentage": 80.0000, "estimated_amount": 1167, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1167.56, "standard_charge_percentage": 80.0000, "estimated_amount": 1167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 437.83, "standard_charge_percentage": 30.0000, "estimated_amount": 437, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 540, "standard_charge_percentage": 37.0000, "estimated_amount": 540, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1313.51, "standard_charge_percentage": 90.0000, "estimated_amount": 1313, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1094.59, "standard_charge_percentage": 75.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1313.51, "standard_charge_percentage": 90.0000, "estimated_amount": 1313, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 583.78, "standard_charge_percentage": 40.0000, "estimated_amount": 583, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1167.56, "standard_charge_percentage": 80.0000, "estimated_amount": 1167, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1386.48, "standard_charge_percentage": 95.0000, "estimated_amount": 1386, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1167.56, "standard_charge_percentage": 80.0000, "estimated_amount": 1167, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1167.56, "standard_charge_percentage": 80.0000, "estimated_amount": 1167, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1021.62, "standard_charge_percentage": 70.0000, "estimated_amount": 1021, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1196.75, "standard_charge_percentage": 82.0000, "estimated_amount": 1196, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1313.51, "standard_charge_percentage": 90.0000, "estimated_amount": 1313, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1094.59, "standard_charge_percentage": 75.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 875.67, "standard_charge_percentage": 60.0000, "estimated_amount": 875, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Perq Dev Place Breast Loc 1St Les W Mammo Guid", "code_information": [ { "code": "19281", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8101.2, "discounted_cash": 1981,"minimum": 66.41,"maximum": 8101.2,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6480.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6480, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6480.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6480, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6480.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6480, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4860.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4860, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6480.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6480, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5670.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5670, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7291.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4860.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6075.9, "standard_charge_percentage": 75.0000, "estimated_amount": 6075, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3240.48, "standard_charge_percentage": 40.0000, "estimated_amount": 3240, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6480.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6480, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2430.36, "standard_charge_percentage": 30.0000, "estimated_amount": 2430, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4536.67, "standard_charge_percentage": 56.0000, "estimated_amount": 4536, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4698.7, "standard_charge_percentage": 58.0000, "estimated_amount": 4698, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7291.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7291, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6075.9, "standard_charge_percentage": 75.0000, "estimated_amount": 6075, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 66.41, "estimated_amount": 66, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7291.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7291, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7291.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7291, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7088.55, "standard_charge_percentage": 87.5000, "estimated_amount": 7088, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8101.2, "standard_charge_percentage": 100.0000, "estimated_amount": 8101, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7696.14, "standard_charge_percentage": 95.0000, "estimated_amount": 7696, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8101.2, "standard_charge_percentage": 100.0000, "estimated_amount": 8101, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6480.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6480, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5670.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5670, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6075.9, "standard_charge_percentage": 75.0000, "estimated_amount": 6075, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2997.44, "standard_charge_percentage": 37.0000, "estimated_amount": 2997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 66.41, "estimated_amount": 66, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6480.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6480, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6075.9, "standard_charge_percentage": 75.0000, "estimated_amount": 6075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4050.6, "standard_charge_percentage": 50.0000, "estimated_amount": 4050, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7291.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7291, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6886.02, "standard_charge_percentage": 85.0000, "estimated_amount": 6886, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7088.55, "standard_charge_percentage": 87.5000, "estimated_amount": 7088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6480.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6480, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6480.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6480, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6075.9, "standard_charge_percentage": 75.0000, "estimated_amount": 6075, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5670.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5670, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6642.98, "standard_charge_percentage": 82.0000, "estimated_amount": 6642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6480.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6480, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7939.18, "standard_charge_percentage": 98.0000, "estimated_amount": 7939, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Device Placemt Breast Loc Ea Les W Guidnce", "code_information": [ { "code": "19282", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5834.18,"minimum": 24.27,"maximum": 5834.18,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4667.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4667, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5250.76, "standard_charge_percentage": 90.0000, "estimated_amount": 5250, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4959.05, "standard_charge_percentage": 85.0000, "estimated_amount": 4959, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5104.91, "standard_charge_percentage": 87.5000, "estimated_amount": 5104, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4667.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4667, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4667.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4667, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4667.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4375.64, "standard_charge_percentage": 75.0000, "estimated_amount": 4375, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5250.76, "standard_charge_percentage": 90.0000, "estimated_amount": 5250, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4375.64, "standard_charge_percentage": 75.0000, "estimated_amount": 4375, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5834.18, "standard_charge_percentage": 100.0000, "estimated_amount": 5834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5542.47, "standard_charge_percentage": 95.0000, "estimated_amount": 5542, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4667.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4667, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4667.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1750.25, "standard_charge_percentage": 30.0000, "estimated_amount": 1750, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4083.93, "standard_charge_percentage": 70.0000, "estimated_amount": 4083, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4375.64, "standard_charge_percentage": 75.0000, "estimated_amount": 4375, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3267.14, "standard_charge_percentage": 56.0000, "estimated_amount": 3267, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3383.82, "standard_charge_percentage": 58.0000, "estimated_amount": 3383, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2158.65, "standard_charge_percentage": 37.0000, "estimated_amount": 2158, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4667.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4667, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5717.5, "standard_charge_percentage": 98.0000, "estimated_amount": 5717, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3500.51, "standard_charge_percentage": 60.0000, "estimated_amount": 3500, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 24.27, "estimated_amount": 24, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4375.64, "standard_charge_percentage": 75.0000, "estimated_amount": 4375, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4375.64, "standard_charge_percentage": 75.0000, "estimated_amount": 4375, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5250.76, "standard_charge_percentage": 90.0000, "estimated_amount": 5250, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3500.51, "standard_charge_percentage": 60.0000, "estimated_amount": 3500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4667.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4667, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4083.93, "standard_charge_percentage": 70.0000, "estimated_amount": 4083, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4083.93, "standard_charge_percentage": 70.0000, "estimated_amount": 4083, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4667.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2917.09, "standard_charge_percentage": 50.0000, "estimated_amount": 2917, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5250.76, "standard_charge_percentage": 90.0000, "estimated_amount": 5250, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2333.67, "standard_charge_percentage": 40.0000, "estimated_amount": 2333, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5104.91, "standard_charge_percentage": 87.5000, "estimated_amount": 5104, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5834.18, "standard_charge_percentage": 100.0000, "estimated_amount": 5834, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4667.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4667, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4784.03, "standard_charge_percentage": 82.0000, "estimated_amount": 4784, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5250.76, "standard_charge_percentage": 90.0000, "estimated_amount": 5250, "methodology": "percent of total billed charges" }]}]} , { "description": "US XTR NON VAS COMPLETE", "code_information": [ { "code": "19285", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3077.23, "discounted_cash": 860,"minimum": 66.41,"maximum": 3077.23,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2769.51, "standard_charge_percentage": 90.0000, "estimated_amount": 2769, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2461.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 923.17, "standard_charge_percentage": 30.0000, "estimated_amount": 923, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2154.06, "standard_charge_percentage": 70.0000, "estimated_amount": 2154, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2523.33, "standard_charge_percentage": 82.0000, "estimated_amount": 2523, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2769.51, "standard_charge_percentage": 90.0000, "estimated_amount": 2769, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 893.54, "estimated_amount": 893, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1224.48, "estimated_amount": 1224, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 869.71, "estimated_amount": 869, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2461.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2461, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2769.51, "standard_charge_percentage": 90.0000, "estimated_amount": 2769, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2615.65, "standard_charge_percentage": 85.0000, "estimated_amount": 2615, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2923.37, "standard_charge_percentage": 95.0000, "estimated_amount": 2923, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1846.34, "standard_charge_percentage": 60.0000, "estimated_amount": 1846, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2461.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2461, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2461.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2307.92, "standard_charge_percentage": 75.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2154.06, "standard_charge_percentage": 70.0000, "estimated_amount": 2154, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2769.51, "standard_charge_percentage": 90.0000, "estimated_amount": 2769, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3015.69, "standard_charge_percentage": 98.0000, "estimated_amount": 3015, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2343.63, "estimated_amount": 2343, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 66.41, "estimated_amount": 66, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 650.66, "estimated_amount": 650, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 857.71, "estimated_amount": 857, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2307.92, "standard_charge_percentage": 75.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2307.92, "standard_charge_percentage": 75.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1538.62, "standard_charge_percentage": 50.0000, "estimated_amount": 1538, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1230.89, "standard_charge_percentage": 40.0000, "estimated_amount": 1230, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2692.58, "standard_charge_percentage": 87.5000, "estimated_amount": 2692, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2461.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2461, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3077.23, "standard_charge_percentage": 100.0000, "estimated_amount": 3077, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2461.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2461, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2154.06, "standard_charge_percentage": 70.0000, "estimated_amount": 2154, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1138.58, "standard_charge_percentage": 37.0000, "estimated_amount": 1138, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2461.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2461, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2307.92, "standard_charge_percentage": 75.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 863.71, "estimated_amount": 863, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 66.41, "estimated_amount": 66, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2461.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2461, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2769.51, "standard_charge_percentage": 90.0000, "estimated_amount": 2769, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2692.58, "standard_charge_percentage": 87.5000, "estimated_amount": 2692, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2461.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2461, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3077.23, "standard_charge_percentage": 100.0000, "estimated_amount": 3077, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2461.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2461, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2307.92, "standard_charge_percentage": 75.0000, "estimated_amount": 2307, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1723.25, "standard_charge_percentage": 56.0000, "estimated_amount": 1723, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1784.79, "standard_charge_percentage": 58.0000, "estimated_amount": 1784, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1846.34, "standard_charge_percentage": 60.0000, "estimated_amount": 1846, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 675.12, "estimated_amount": 675, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1323.76, "estimated_amount": 1323, "methodology": "fee schedule" }]}]} , { "description": "US XTR NON VASC LMTD", "code_information": [ { "code": "19286", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 704.48,"minimum": 20.96,"maximum": 704.48,"payers_information":[{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 616.42, "standard_charge_percentage": 87.5000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 616.42, "standard_charge_percentage": 87.5000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 704.48, "standard_charge_percentage": 100.0000, "estimated_amount": 704, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 704.48, "standard_charge_percentage": 100.0000, "estimated_amount": 704, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 422.69, "standard_charge_percentage": 60.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 211.34, "standard_charge_percentage": 30.0000, "estimated_amount": 211, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 528.36, "standard_charge_percentage": 75.0000, "estimated_amount": 528, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 493.14, "standard_charge_percentage": 70.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 493.14, "standard_charge_percentage": 70.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 528.36, "standard_charge_percentage": 75.0000, "estimated_amount": 528, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 408.6, "standard_charge_percentage": 58.0000, "estimated_amount": 408, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 690.39, "standard_charge_percentage": 98.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 422.69, "standard_charge_percentage": 60.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 20.96, "estimated_amount": 20, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 704.48, "estimated_amount": 704, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 528.36, "standard_charge_percentage": 75.0000, "estimated_amount": 528, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 634.03, "standard_charge_percentage": 90.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 598.81, "standard_charge_percentage": 85.0000, "estimated_amount": 598, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 493.14, "standard_charge_percentage": 70.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 260.66, "standard_charge_percentage": 37.0000, "estimated_amount": 260, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 634.03, "standard_charge_percentage": 90.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 352.24, "standard_charge_percentage": 50.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 634.03, "standard_charge_percentage": 90.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 281.79, "standard_charge_percentage": 40.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 669.26, "standard_charge_percentage": 95.0000, "estimated_amount": 669, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 634.03, "standard_charge_percentage": 90.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 528.36, "standard_charge_percentage": 75.0000, "estimated_amount": 528, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 528.36, "standard_charge_percentage": 75.0000, "estimated_amount": 528, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 634.03, "standard_charge_percentage": 90.0000, "estimated_amount": 634, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 577.67, "standard_charge_percentage": 82.0000, "estimated_amount": 577, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 394.51, "standard_charge_percentage": 56.0000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 563.58, "standard_charge_percentage": 80.0000, "estimated_amount": 563, "methodology": "percent of total billed charges" }]}]} , { "description": "Partial mastectomy", "code_information": [ { "code": "19301", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 14947.5, "discounted_cash": 4682,"minimum": 801.08,"maximum": 14947.5,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 801.08, "estimated_amount": 801, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 3264.39, "estimated_amount": 3264, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4668.08, "estimated_amount": 4668, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 11210.6, "standard_charge_percentage": 75.0000, "estimated_amount": 11210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 7473.75, "standard_charge_percentage": 50.0000, "estimated_amount": 7473, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 13452.8, "standard_charge_percentage": 90.0000, "estimated_amount": 13452, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 8968.5, "standard_charge_percentage": 60.0000, "estimated_amount": 8968, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 11958, "standard_charge_percentage": 80.0000, "estimated_amount": 11958, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 11958, "standard_charge_percentage": 80.0000, "estimated_amount": 11958, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 10463.3, "standard_charge_percentage": 70.0000, "estimated_amount": 10463, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 12257, "standard_charge_percentage": 82.0000, "estimated_amount": 12256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 6664.22, "estimated_amount": 6664, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 7204.56, "estimated_amount": 7204, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4700.72, "estimated_amount": 4700, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 3264.39, "estimated_amount": 3264, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 3446.73, "estimated_amount": 3446, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4733.37, "estimated_amount": 4733, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5979, "standard_charge_percentage": 40.0000, "estimated_amount": 5979, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 13079.1, "standard_charge_percentage": 87.5000, "estimated_amount": 13079, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 11958, "standard_charge_percentage": 80.0000, "estimated_amount": 11958, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 14200.1, "standard_charge_percentage": 95.0000, "estimated_amount": 14200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 11210.6, "standard_charge_percentage": 75.0000, "estimated_amount": 11210, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 10463.3, "standard_charge_percentage": 70.0000, "estimated_amount": 10463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 11958, "standard_charge_percentage": 80.0000, "estimated_amount": 11958, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 13452.8, "standard_charge_percentage": 90.0000, "estimated_amount": 13452, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 14648.5, "standard_charge_percentage": 98.0000, "estimated_amount": 14648, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 11210.6, "standard_charge_percentage": 75.0000, "estimated_amount": 11210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 8968.5, "standard_charge_percentage": 60.0000, "estimated_amount": 8968, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 5043.19, "estimated_amount": 5043, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 12755.2, "estimated_amount": 12755, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 5763.65, "estimated_amount": 5763, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3782.39, "estimated_amount": 3782, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 13452.8, "standard_charge_percentage": 90.0000, "estimated_amount": 13452, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 13452.8, "standard_charge_percentage": 90.0000, "estimated_amount": 13452, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 13079.1, "standard_charge_percentage": 87.5000, "estimated_amount": 13079, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 14947.5, "standard_charge_percentage": 100.0000, "estimated_amount": 14947, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 14947.5, "standard_charge_percentage": 100.0000, "estimated_amount": 14947, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 11958, "standard_charge_percentage": 80.0000, "estimated_amount": 11958, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 11210.6, "standard_charge_percentage": 75.0000, "estimated_amount": 11210, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 13452.8, "standard_charge_percentage": 90.0000, "estimated_amount": 13452, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3782.39, "estimated_amount": 3782, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3674.33, "estimated_amount": 3674, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4863.08, "estimated_amount": 4863, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 5043.19, "estimated_amount": 5043, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 11210.6, "standard_charge_percentage": 75.0000, "estimated_amount": 11210, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 11958, "standard_charge_percentage": 80.0000, "estimated_amount": 11958, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 11958, "standard_charge_percentage": 80.0000, "estimated_amount": 11958, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 12705.4, "standard_charge_percentage": 85.0000, "estimated_amount": 12705, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 11958, "standard_charge_percentage": 80.0000, "estimated_amount": 11958, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 11958, "standard_charge_percentage": 80.0000, "estimated_amount": 11958, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 11958, "standard_charge_percentage": 80.0000, "estimated_amount": 11958, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4484.25, "standard_charge_percentage": 30.0000, "estimated_amount": 4484, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 10463.3, "standard_charge_percentage": 70.0000, "estimated_amount": 10463, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8370.6, "standard_charge_percentage": 56.0000, "estimated_amount": 8370, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 8669.55, "standard_charge_percentage": 58.0000, "estimated_amount": 8669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 5763.65, "estimated_amount": 5763, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "19303", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 12536.5, "discounted_cash": 7975,"minimum": 1164.16,"maximum": 12536.5,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 5559.42, "estimated_amount": 5559, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 7949.97, "estimated_amount": 7949, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 10029.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10029, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 10029.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10029, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 12536.5, "standard_charge_percentage": 100.0000, "estimated_amount": 12536, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 10029.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10029, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 10029.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10029, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3760.93, "standard_charge_percentage": 30.0000, "estimated_amount": 3760, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 8775.51, "standard_charge_percentage": 70.0000, "estimated_amount": 8775, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 8775.51, "standard_charge_percentage": 70.0000, "estimated_amount": 8775, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 9402.34, "standard_charge_percentage": 75.0000, "estimated_amount": 9402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6134.86, "estimated_amount": 6134, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6134.86, "estimated_amount": 6134, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6134.86, "estimated_amount": 6134, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6257.56, "estimated_amount": 6257, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6134.86, "estimated_amount": 6134, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 8588.8, "estimated_amount": 8588, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1164.16, "estimated_amount": 1164, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 9402.34, "standard_charge_percentage": 75.0000, "estimated_amount": 9402, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 10029.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10029, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 11282.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11282, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 10656, "standard_charge_percentage": 85.0000, "estimated_amount": 10655, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 10029.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10029, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 7521.87, "standard_charge_percentage": 60.0000, "estimated_amount": 7521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 9402.34, "standard_charge_percentage": 75.0000, "estimated_amount": 9402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 10029.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10029, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 11282.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11282, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 11282.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11282, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 8588.8, "estimated_amount": 8588, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6134.86, "estimated_amount": 6134, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6134.86, "estimated_amount": 6134, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 9815.78, "estimated_amount": 9815, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 12269.7, "estimated_amount": 12269, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 9402.34, "standard_charge_percentage": 75.0000, "estimated_amount": 9402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6268.23, "standard_charge_percentage": 50.0000, "estimated_amount": 6268, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5014.58, "standard_charge_percentage": 40.0000, "estimated_amount": 5014, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 10969.4, "standard_charge_percentage": 87.5000, "estimated_amount": 10969, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 10029.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10029, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 12536.5, "standard_charge_percentage": 100.0000, "estimated_amount": 12536, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 10029.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10029, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 10029.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10029, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 10279.9, "standard_charge_percentage": 82.0000, "estimated_amount": 10279, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 12285.7, "standard_charge_percentage": 98.0000, "estimated_amount": 12285, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 7521.87, "standard_charge_percentage": 60.0000, "estimated_amount": 7521, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6134.86, "estimated_amount": 6134, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 12536.5, "estimated_amount": 12536, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 8282.06, "estimated_amount": 8282, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 9815.78, "estimated_amount": 9815, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 6441.6, "estimated_amount": 6441, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6134.86, "estimated_amount": 6134, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8005.56, "estimated_amount": 8005, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 5559.42, "estimated_amount": 5559, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 5958.6, "estimated_amount": 5958, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8061.16, "estimated_amount": 8061, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1403, "estimated_amount": 1403, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 11282.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11282, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 11282.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11282, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 10969.4, "standard_charge_percentage": 87.5000, "estimated_amount": 10969, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 11909.6, "standard_charge_percentage": 95.0000, "estimated_amount": 11909, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 8775.51, "standard_charge_percentage": 70.0000, "estimated_amount": 8775, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 7020.41, "standard_charge_percentage": 56.0000, "estimated_amount": 7020, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 7271.14, "standard_charge_percentage": 58.0000, "estimated_amount": 7271, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 9402.34, "standard_charge_percentage": 75.0000, "estimated_amount": 9402, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6134.86, "estimated_amount": 6134, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 6441.6, "estimated_amount": 6441, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6134.86, "estimated_amount": 6134, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 11349.5, "estimated_amount": 11349, "methodology": "fee schedule" }]}]} , { "description": "Hc Unlisted Procedure Breast", "code_information": [ { "code": "19499", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18703.7, "discounted_cash": 4682,"minimum": 1611.86,"maximum": 18703.7,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 3264.39, "estimated_amount": 3264, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 14963, "standard_charge_percentage": 80.0000, "estimated_amount": 14962, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 16833.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16833, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7481.48, "standard_charge_percentage": 40.0000, "estimated_amount": 7481, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 14963, "standard_charge_percentage": 80.0000, "estimated_amount": 14962, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 14963, "standard_charge_percentage": 80.0000, "estimated_amount": 14962, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 17768.5, "standard_charge_percentage": 95.0000, "estimated_amount": 17768, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 14027.8, "standard_charge_percentage": 75.0000, "estimated_amount": 14027, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 16833.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16833, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 18329.6, "standard_charge_percentage": 98.0000, "estimated_amount": 18329, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 14027.8, "standard_charge_percentage": 75.0000, "estimated_amount": 14027, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 6664.22, "estimated_amount": 6664, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4700.72, "estimated_amount": 4700, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 3264.39, "estimated_amount": 3264, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 3446.73, "estimated_amount": 3446, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 14027.8, "standard_charge_percentage": 75.0000, "estimated_amount": 14027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14963, "standard_charge_percentage": 80.0000, "estimated_amount": 14962, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 16833.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 16365.7, "standard_charge_percentage": 87.5000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 14963, "standard_charge_percentage": 80.0000, "estimated_amount": 14962, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 11222.2, "standard_charge_percentage": 60.0000, "estimated_amount": 11222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14963, "standard_charge_percentage": 80.0000, "estimated_amount": 14962, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 11222.2, "standard_charge_percentage": 60.0000, "estimated_amount": 11222, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4863.08, "estimated_amount": 4863, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 5763.65, "estimated_amount": 5763, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3782.39, "estimated_amount": 3782, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 5763.65, "estimated_amount": 5763, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 7204.56, "estimated_amount": 7204, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4668.08, "estimated_amount": 4668, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 16833.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16833, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 15898.2, "standard_charge_percentage": 85.0000, "estimated_amount": 15898, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 16365.7, "standard_charge_percentage": 87.5000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 18703.7, "standard_charge_percentage": 100.0000, "estimated_amount": 18703, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 18703.7, "standard_charge_percentage": 100.0000, "estimated_amount": 18703, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 14963, "standard_charge_percentage": 80.0000, "estimated_amount": 14962, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 14963, "standard_charge_percentage": 80.0000, "estimated_amount": 14962, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5611.11, "standard_charge_percentage": 30.0000, "estimated_amount": 5611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 14027.8, "standard_charge_percentage": 75.0000, "estimated_amount": 14027, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 13092.6, "standard_charge_percentage": 70.0000, "estimated_amount": 13092, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 13092.6, "standard_charge_percentage": 70.0000, "estimated_amount": 13092, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 13092.6, "standard_charge_percentage": 70.0000, "estimated_amount": 13092, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 15337, "standard_charge_percentage": 82.0000, "estimated_amount": 15337, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 6920.37, "standard_charge_percentage": 37.0000, "estimated_amount": 6920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 16833.3, "standard_charge_percentage": 90.0000, "estimated_amount": 16833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 5043.19, "estimated_amount": 5043, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3782.39, "estimated_amount": 3782, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1611.86, "estimated_amount": 1611, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4733.37, "estimated_amount": 4733, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 14027.8, "standard_charge_percentage": 75.0000, "estimated_amount": 14027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9351.85, "standard_charge_percentage": 50.0000, "estimated_amount": 9351, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 14963, "standard_charge_percentage": 80.0000, "estimated_amount": 14962, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10474.1, "standard_charge_percentage": 56.0000, "estimated_amount": 10474, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 10848.2, "standard_charge_percentage": 58.0000, "estimated_amount": 10848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14963, "standard_charge_percentage": 80.0000, "estimated_amount": 14962, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 12755.2, "estimated_amount": 12755, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3674.33, "estimated_amount": 3674, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 5043.19, "estimated_amount": 5043, "methodology": "fee schedule" }]}]} , { "description": "INJECT INTO SPINAL ARTERY", "code_information": [ { "code": "20206", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7955.46, "discounted_cash": 1981,"minimum": 525.22,"maximum": 7955.46,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7159.91, "standard_charge_percentage": 90.0000, "estimated_amount": 7159, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7159.91, "standard_charge_percentage": 90.0000, "estimated_amount": 7159, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6762.14, "standard_charge_percentage": 85.0000, "estimated_amount": 6762, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7955.46, "standard_charge_percentage": 100.0000, "estimated_amount": 7955, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4773.28, "standard_charge_percentage": 60.0000, "estimated_amount": 4773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2386.64, "standard_charge_percentage": 30.0000, "estimated_amount": 2386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5966.6, "standard_charge_percentage": 75.0000, "estimated_amount": 5966, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5568.82, "standard_charge_percentage": 70.0000, "estimated_amount": 5568, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5568.82, "standard_charge_percentage": 70.0000, "estimated_amount": 5568, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5568.82, "standard_charge_percentage": 70.0000, "estimated_amount": 5568, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6523.48, "standard_charge_percentage": 82.0000, "estimated_amount": 6523, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6364.37, "standard_charge_percentage": 80.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4773.28, "standard_charge_percentage": 60.0000, "estimated_amount": 4773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5966.6, "standard_charge_percentage": 75.0000, "estimated_amount": 5966, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3182.18, "standard_charge_percentage": 40.0000, "estimated_amount": 3182, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6961.03, "standard_charge_percentage": 87.5000, "estimated_amount": 6961, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6364.37, "standard_charge_percentage": 80.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6364.37, "standard_charge_percentage": 80.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5966.6, "standard_charge_percentage": 75.0000, "estimated_amount": 5966, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4614.17, "standard_charge_percentage": 58.0000, "estimated_amount": 4614, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7159.91, "standard_charge_percentage": 90.0000, "estimated_amount": 7159, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7796.35, "standard_charge_percentage": 98.0000, "estimated_amount": 7796, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5966.6, "standard_charge_percentage": 75.0000, "estimated_amount": 5966, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5966.6, "standard_charge_percentage": 75.0000, "estimated_amount": 5966, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6364.37, "standard_charge_percentage": 80.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3977.73, "standard_charge_percentage": 50.0000, "estimated_amount": 3977, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7159.91, "standard_charge_percentage": 90.0000, "estimated_amount": 7159, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6961.03, "standard_charge_percentage": 87.5000, "estimated_amount": 6961, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6364.37, "standard_charge_percentage": 80.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6364.37, "standard_charge_percentage": 80.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6364.37, "standard_charge_percentage": 80.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2943.52, "standard_charge_percentage": 37.0000, "estimated_amount": 2943, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7159.91, "standard_charge_percentage": 90.0000, "estimated_amount": 7159, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6364.37, "standard_charge_percentage": 80.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6364.37, "standard_charge_percentage": 80.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7955.46, "standard_charge_percentage": 100.0000, "estimated_amount": 7955, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7557.69, "standard_charge_percentage": 95.0000, "estimated_amount": 7557, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6364.37, "standard_charge_percentage": 80.0000, "estimated_amount": 6364, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4455.06, "standard_charge_percentage": 56.0000, "estimated_amount": 4455, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" }]}]} , { "description": "EPI STEROID INJ CERV/THORA-PC", "code_information": [ { "code": "20220", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7851.2, "discounted_cash": 1981,"minimum": 525.22,"maximum": 7851.2,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6673.52, "standard_charge_percentage": 85.0000, "estimated_amount": 6673, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6869.8, "standard_charge_percentage": 87.5000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5495.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5495, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6437.98, "standard_charge_percentage": 82.0000, "estimated_amount": 6437, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4553.7, "standard_charge_percentage": 58.0000, "estimated_amount": 4553, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6869.8, "standard_charge_percentage": 87.5000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7851.2, "standard_charge_percentage": 100.0000, "estimated_amount": 7851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5495.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5495, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4710.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4710, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3925.6, "standard_charge_percentage": 50.0000, "estimated_amount": 3925, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2355.36, "standard_charge_percentage": 30.0000, "estimated_amount": 2355, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4396.67, "standard_charge_percentage": 56.0000, "estimated_amount": 4396, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2904.94, "standard_charge_percentage": 37.0000, "estimated_amount": 2904, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7694.18, "standard_charge_percentage": 98.0000, "estimated_amount": 7694, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3140.48, "standard_charge_percentage": 40.0000, "estimated_amount": 3140, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7458.64, "standard_charge_percentage": 95.0000, "estimated_amount": 7458, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7851.2, "standard_charge_percentage": 100.0000, "estimated_amount": 7851, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4710.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4710, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5495.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5495, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" }]}]} , { "description": "Hc Bone Biopsy,Trocar/Needle Deep", "code_information": [ { "code": "20225", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5019.72, "discounted_cash": 1981,"minimum": 525.22,"maximum": 5019.72,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3764.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3764, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 4517.75, "standard_charge_percentage": 90.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 4517.75, "standard_charge_percentage": 90.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4266.76, "standard_charge_percentage": 85.0000, "estimated_amount": 4266, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 4392.26, "standard_charge_percentage": 87.5000, "estimated_amount": 4392, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3513.8, "standard_charge_percentage": 70.0000, "estimated_amount": 3513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3011.83, "standard_charge_percentage": 60.0000, "estimated_amount": 3011, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5019.72, "estimated_amount": 5019, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2509.86, "standard_charge_percentage": 50.0000, "estimated_amount": 2509, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 4392.26, "standard_charge_percentage": 87.5000, "estimated_amount": 4392, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3764.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3764, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3764.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3764, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4116.17, "standard_charge_percentage": 82.0000, "estimated_amount": 4116, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 4517.75, "standard_charge_percentage": 90.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 4517.75, "standard_charge_percentage": 90.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3764.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3764.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3764, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 4517.75, "standard_charge_percentage": 90.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2007.89, "standard_charge_percentage": 40.0000, "estimated_amount": 2007, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5019.72, "standard_charge_percentage": 100.0000, "estimated_amount": 5019, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 4768.73, "standard_charge_percentage": 95.0000, "estimated_amount": 4768, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5019.72, "standard_charge_percentage": 100.0000, "estimated_amount": 5019, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3011.83, "standard_charge_percentage": 60.0000, "estimated_amount": 3011, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1505.92, "standard_charge_percentage": 30.0000, "estimated_amount": 1505, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3513.8, "standard_charge_percentage": 70.0000, "estimated_amount": 3513, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3513.8, "standard_charge_percentage": 70.0000, "estimated_amount": 3513, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1857.3, "standard_charge_percentage": 37.0000, "estimated_amount": 1857, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 4919.33, "standard_charge_percentage": 98.0000, "estimated_amount": 4919, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2811.04, "standard_charge_percentage": 56.0000, "estimated_amount": 2811, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2911.44, "standard_charge_percentage": 58.0000, "estimated_amount": 2911, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" }]}]} , { "description": "Hc Inject Sinus Tract For Dx W Xray", "code_information": [ { "code": "20501", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 520.9,"minimum": 156.27,"maximum": 520.9,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 416.72, "standard_charge_percentage": 80.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 468.81, "standard_charge_percentage": 90.0000, "estimated_amount": 468, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 468.81, "standard_charge_percentage": 90.0000, "estimated_amount": 468, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 455.79, "standard_charge_percentage": 87.5000, "estimated_amount": 455, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 494.86, "standard_charge_percentage": 95.0000, "estimated_amount": 494, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 520.9, "standard_charge_percentage": 100.0000, "estimated_amount": 520, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 312.54, "standard_charge_percentage": 60.0000, "estimated_amount": 312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 390.68, "standard_charge_percentage": 75.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 364.63, "standard_charge_percentage": 70.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 390.68, "standard_charge_percentage": 75.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 468.81, "standard_charge_percentage": 90.0000, "estimated_amount": 468, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 390.68, "standard_charge_percentage": 75.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 390.68, "standard_charge_percentage": 75.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 260.45, "standard_charge_percentage": 50.0000, "estimated_amount": 260, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 468.81, "standard_charge_percentage": 90.0000, "estimated_amount": 468, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 416.72, "standard_charge_percentage": 80.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 416.72, "standard_charge_percentage": 80.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 416.72, "standard_charge_percentage": 80.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 364.63, "standard_charge_percentage": 70.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 192.73, "standard_charge_percentage": 37.0000, "estimated_amount": 192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 312.54, "standard_charge_percentage": 60.0000, "estimated_amount": 312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 174.72, "estimated_amount": 174, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 416.72, "standard_charge_percentage": 80.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 208.36, "standard_charge_percentage": 40.0000, "estimated_amount": 208, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 416.72, "standard_charge_percentage": 80.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 416.72, "standard_charge_percentage": 80.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 520.9, "standard_charge_percentage": 100.0000, "estimated_amount": 520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 156.27, "standard_charge_percentage": 30.0000, "estimated_amount": 156, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 364.63, "standard_charge_percentage": 70.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 427.14, "standard_charge_percentage": 82.0000, "estimated_amount": 427, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 302.12, "standard_charge_percentage": 58.0000, "estimated_amount": 302, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 510.48, "standard_charge_percentage": 98.0000, "estimated_amount": 510, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 390.68, "standard_charge_percentage": 75.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 520.9, "estimated_amount": 520, "methodology": "case rate" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 442.76, "standard_charge_percentage": 85.0000, "estimated_amount": 442, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 455.79, "standard_charge_percentage": 87.5000, "estimated_amount": 455, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 416.72, "standard_charge_percentage": 80.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 416.72, "standard_charge_percentage": 80.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 291.7, "standard_charge_percentage": 56.0000, "estimated_amount": 291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 416.72, "standard_charge_percentage": 80.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 468.81, "standard_charge_percentage": 90.0000, "estimated_amount": 468, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Inject Tendon Sheath/Ligament", "code_information": [ { "code": "20550", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 803.15, "discounted_cash": 360,"minimum": 192.19,"maximum": 803.15,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 642.52, "standard_charge_percentage": 80.0000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 658.58, "standard_charge_percentage": 82.0000, "estimated_amount": 658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 359.86, "estimated_amount": 359, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 803.15, "estimated_amount": 803, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 642.52, "standard_charge_percentage": 80.0000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 401.57, "standard_charge_percentage": 50.0000, "estimated_amount": 401, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 321.26, "standard_charge_percentage": 40.0000, "estimated_amount": 321, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 702.76, "standard_charge_percentage": 87.5000, "estimated_amount": 702, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 642.52, "standard_charge_percentage": 80.0000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 803.15, "standard_charge_percentage": 100.0000, "estimated_amount": 803, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 481.89, "standard_charge_percentage": 60.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 642.52, "standard_charge_percentage": 80.0000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 240.94, "standard_charge_percentage": 30.0000, "estimated_amount": 240, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 562.21, "standard_charge_percentage": 70.0000, "estimated_amount": 562, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 562.21, "standard_charge_percentage": 70.0000, "estimated_amount": 562, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 465.83, "standard_charge_percentage": 58.0000, "estimated_amount": 465, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 297.17, "standard_charge_percentage": 37.0000, "estimated_amount": 297, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 642.52, "standard_charge_percentage": 80.0000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 722.84, "standard_charge_percentage": 90.0000, "estimated_amount": 722, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 283.24, "estimated_amount": 283, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 362.38, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 192.19, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 602.36, "standard_charge_percentage": 75.0000, "estimated_amount": 602, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 722.84, "standard_charge_percentage": 90.0000, "estimated_amount": 722, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 642.52, "standard_charge_percentage": 80.0000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 762.99, "standard_charge_percentage": 95.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 642.52, "standard_charge_percentage": 80.0000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 642.52, "standard_charge_percentage": 80.0000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 602.36, "standard_charge_percentage": 75.0000, "estimated_amount": 602, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 602.36, "standard_charge_percentage": 75.0000, "estimated_amount": 602, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 722.84, "standard_charge_percentage": 90.0000, "estimated_amount": 722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 374.88, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 513.73, "estimated_amount": 513, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 555.38, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 272.6, "estimated_amount": 272, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 364.89, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 602.36, "standard_charge_percentage": 75.0000, "estimated_amount": 602, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 722.84, "standard_charge_percentage": 90.0000, "estimated_amount": 722, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 722.84, "standard_charge_percentage": 90.0000, "estimated_amount": 722, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 682.68, "standard_charge_percentage": 85.0000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 702.76, "standard_charge_percentage": 87.5000, "estimated_amount": 702, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 642.52, "standard_charge_percentage": 80.0000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 803.15, "standard_charge_percentage": 100.0000, "estimated_amount": 803, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 642.52, "standard_charge_percentage": 80.0000, "estimated_amount": 642, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 562.21, "standard_charge_percentage": 70.0000, "estimated_amount": 562, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 449.76, "standard_charge_percentage": 56.0000, "estimated_amount": 449, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 787.09, "standard_charge_percentage": 98.0000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 602.36, "standard_charge_percentage": 75.0000, "estimated_amount": 602, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 481.89, "standard_charge_percentage": 60.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 803.15, "estimated_amount": 803, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" }]}]} , { "description": "Hc Inject Tendon Origin/Insert", "code_information": [ { "code": "20551", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1498.28, "discounted_cash": 360,"minimum": 192.19,"maximum": 1498.28,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 599.31, "standard_charge_percentage": 40.0000, "estimated_amount": 599, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 554.36, "standard_charge_percentage": 37.0000, "estimated_amount": 554, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 898.97, "standard_charge_percentage": 60.0000, "estimated_amount": 898, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 192.19, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1498.28, "estimated_amount": 1498, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1273.54, "standard_charge_percentage": 85.0000, "estimated_amount": 1273, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1310.99, "standard_charge_percentage": 87.5000, "estimated_amount": 1310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 449.48, "standard_charge_percentage": 30.0000, "estimated_amount": 449, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1048.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1048.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 869, "standard_charge_percentage": 58.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 983.26, "estimated_amount": 983, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 283.24, "estimated_amount": 283, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 272.6, "estimated_amount": 272, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 364.89, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 359.86, "estimated_amount": 359, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 749.14, "standard_charge_percentage": 50.0000, "estimated_amount": 749, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1498.28, "standard_charge_percentage": 100.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 898.97, "standard_charge_percentage": 60.0000, "estimated_amount": 898, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1468.31, "standard_charge_percentage": 98.0000, "estimated_amount": 1468, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 374.88, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 513.73, "estimated_amount": 513, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 555.38, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 362.38, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1310.99, "standard_charge_percentage": 87.5000, "estimated_amount": 1310, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1423.37, "standard_charge_percentage": 95.0000, "estimated_amount": 1423, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1498.28, "standard_charge_percentage": 100.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1048.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1228.59, "standard_charge_percentage": 82.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 839.04, "standard_charge_percentage": 56.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" }]}]} , { "description": "Hc Inject Trigger Point1-2 Muscle", "code_information": [ { "code": "20552", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1498.28, "discounted_cash": 360,"minimum": 192.19,"maximum": 1498.28,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 272.6, "estimated_amount": 272, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 364.89, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 599.31, "standard_charge_percentage": 40.0000, "estimated_amount": 599, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 554.36, "standard_charge_percentage": 37.0000, "estimated_amount": 554, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 374.88, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 513.73, "estimated_amount": 513, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 555.38, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1498.28, "estimated_amount": 1498, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 898.97, "standard_charge_percentage": 60.0000, "estimated_amount": 898, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 449.48, "standard_charge_percentage": 30.0000, "estimated_amount": 449, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1048.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1048.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 869, "standard_charge_percentage": 58.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1468.31, "standard_charge_percentage": 98.0000, "estimated_amount": 1468, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 359.86, "estimated_amount": 359, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 749.14, "standard_charge_percentage": 50.0000, "estimated_amount": 749, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1273.54, "standard_charge_percentage": 85.0000, "estimated_amount": 1273, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1310.99, "standard_charge_percentage": 87.5000, "estimated_amount": 1310, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1498.28, "standard_charge_percentage": 100.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 362.38, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 192.19, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1310.99, "standard_charge_percentage": 87.5000, "estimated_amount": 1310, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1423.37, "standard_charge_percentage": 95.0000, "estimated_amount": 1423, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1498.28, "standard_charge_percentage": 100.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1048.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1228.59, "standard_charge_percentage": 82.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 839.04, "standard_charge_percentage": 56.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 898.97, "standard_charge_percentage": 60.0000, "estimated_amount": 898, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 983.26, "estimated_amount": 983, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 283.24, "estimated_amount": 283, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" }]}]} , { "description": "Hc Inject Trigger Points, > 3", "code_information": [ { "code": "20553", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1159.99, "discounted_cash": 360,"minimum": 192.19,"maximum": 1159.99,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 272.6, "estimated_amount": 272, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1159.99, "estimated_amount": 1159, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 869.99, "standard_charge_percentage": 75.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 927.99, "standard_charge_percentage": 80.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1043.99, "standard_charge_percentage": 90.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1014.99, "standard_charge_percentage": 87.5000, "estimated_amount": 1014, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 927.99, "standard_charge_percentage": 80.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1159.99, "standard_charge_percentage": 100.0000, "estimated_amount": 1159, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1043.99, "standard_charge_percentage": 90.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1136.79, "standard_charge_percentage": 98.0000, "estimated_amount": 1136, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 983.26, "estimated_amount": 983, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 283.24, "estimated_amount": 283, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 192.19, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1043.99, "standard_charge_percentage": 90.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1014.99, "standard_charge_percentage": 87.5000, "estimated_amount": 1014, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 927.99, "standard_charge_percentage": 80.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 695.99, "standard_charge_percentage": 60.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 927.99, "standard_charge_percentage": 80.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 811.99, "standard_charge_percentage": 70.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 869.99, "standard_charge_percentage": 75.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 951.19, "standard_charge_percentage": 82.0000, "estimated_amount": 951, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 429.2, "standard_charge_percentage": 37.0000, "estimated_amount": 429, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 364.89, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 359.86, "estimated_amount": 359, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 869.99, "standard_charge_percentage": 75.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 927.99, "standard_charge_percentage": 80.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 580, "standard_charge_percentage": 50.0000, "estimated_amount": 580, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 464, "standard_charge_percentage": 40.0000, "estimated_amount": 464, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1101.99, "standard_charge_percentage": 95.0000, "estimated_amount": 1101, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 927.99, "standard_charge_percentage": 80.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 927.99, "standard_charge_percentage": 80.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 811.99, "standard_charge_percentage": 70.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 927.99, "standard_charge_percentage": 80.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1043.99, "standard_charge_percentage": 90.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 869.99, "standard_charge_percentage": 75.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 695.99, "standard_charge_percentage": 60.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 362.38, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1043.99, "standard_charge_percentage": 90.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 985.99, "standard_charge_percentage": 85.0000, "estimated_amount": 985, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 927.99, "standard_charge_percentage": 80.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1159.99, "standard_charge_percentage": 100.0000, "estimated_amount": 1159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 927.99, "standard_charge_percentage": 80.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 348, "standard_charge_percentage": 30.0000, "estimated_amount": 348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 869.99, "standard_charge_percentage": 75.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 811.99, "standard_charge_percentage": 70.0000, "estimated_amount": 811, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 649.59, "standard_charge_percentage": 56.0000, "estimated_amount": 649, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 672.79, "standard_charge_percentage": 58.0000, "estimated_amount": 672, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 374.88, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 513.73, "estimated_amount": 513, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 555.38, "estimated_amount": 555, "methodology": "fee schedule" }]}]} , { "description": "Hc Drain/Inject Small Joint/Bursa", "code_information": [ { "code": "20600", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1498.28, "discounted_cash": 360,"minimum": 192.19,"maximum": 1498.28,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 192.19, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 359.86, "estimated_amount": 359, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1273.54, "standard_charge_percentage": 85.0000, "estimated_amount": 1273, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1310.99, "standard_charge_percentage": 87.5000, "estimated_amount": 1310, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1498.28, "standard_charge_percentage": 100.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1423.37, "standard_charge_percentage": 95.0000, "estimated_amount": 1423, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 898.97, "standard_charge_percentage": 60.0000, "estimated_amount": 898, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1228.59, "standard_charge_percentage": 82.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 272.6, "estimated_amount": 272, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 599.31, "standard_charge_percentage": 40.0000, "estimated_amount": 599, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1498.28, "standard_charge_percentage": 100.0000, "estimated_amount": 1498, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 554.36, "standard_charge_percentage": 37.0000, "estimated_amount": 554, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 898.97, "standard_charge_percentage": 60.0000, "estimated_amount": 898, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 983.26, "estimated_amount": 983, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 364.89, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 749.14, "standard_charge_percentage": 50.0000, "estimated_amount": 749, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 449.48, "standard_charge_percentage": 30.0000, "estimated_amount": 449, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 869, "standard_charge_percentage": 58.0000, "estimated_amount": 869, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1468.31, "standard_charge_percentage": 98.0000, "estimated_amount": 1468, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 362.38, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1498.28, "estimated_amount": 1498, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1123.71, "standard_charge_percentage": 75.0000, "estimated_amount": 1123, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1310.99, "standard_charge_percentage": 87.5000, "estimated_amount": 1310, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1198.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1198, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1048.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1048.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1048.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 839.04, "standard_charge_percentage": 56.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1348.45, "standard_charge_percentage": 90.0000, "estimated_amount": 1348, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 283.24, "estimated_amount": 283, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 374.88, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 513.73, "estimated_amount": 513, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 555.38, "estimated_amount": 555, "methodology": "fee schedule" }]}]} , { "description": "Hc Drain/Inject Intermediate Joint/Bursa", "code_information": [ { "code": "20605", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1405.53, "discounted_cash": 360,"minimum": 192.19,"maximum": 1405.53,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 359.86, "estimated_amount": 359, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1264.98, "standard_charge_percentage": 90.0000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 562.21, "standard_charge_percentage": 40.0000, "estimated_amount": 562, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1229.84, "standard_charge_percentage": 87.5000, "estimated_amount": 1229, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1124.42, "standard_charge_percentage": 80.0000, "estimated_amount": 1124, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1124.42, "standard_charge_percentage": 80.0000, "estimated_amount": 1124, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1335.25, "standard_charge_percentage": 95.0000, "estimated_amount": 1335, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1124.42, "standard_charge_percentage": 80.0000, "estimated_amount": 1124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1054.15, "standard_charge_percentage": 75.0000, "estimated_amount": 1054, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 983.87, "standard_charge_percentage": 70.0000, "estimated_amount": 983, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1264.98, "standard_charge_percentage": 90.0000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1264.98, "standard_charge_percentage": 90.0000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1377.42, "standard_charge_percentage": 98.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 374.88, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 513.73, "estimated_amount": 513, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 555.38, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 362.38, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1124.42, "standard_charge_percentage": 80.0000, "estimated_amount": 1124, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1229.84, "standard_charge_percentage": 87.5000, "estimated_amount": 1229, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1405.53, "standard_charge_percentage": 100.0000, "estimated_amount": 1405, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1124.42, "standard_charge_percentage": 80.0000, "estimated_amount": 1124, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 983.87, "standard_charge_percentage": 70.0000, "estimated_amount": 983, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 787.1, "standard_charge_percentage": 56.0000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 815.21, "standard_charge_percentage": 58.0000, "estimated_amount": 815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1124.42, "standard_charge_percentage": 80.0000, "estimated_amount": 1124, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 272.6, "estimated_amount": 272, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 364.89, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1405.53, "estimated_amount": 1405, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1264.98, "standard_charge_percentage": 90.0000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1405.53, "standard_charge_percentage": 100.0000, "estimated_amount": 1405, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1124.42, "standard_charge_percentage": 80.0000, "estimated_amount": 1124, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1124.42, "standard_charge_percentage": 80.0000, "estimated_amount": 1124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 421.66, "standard_charge_percentage": 30.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 983.87, "standard_charge_percentage": 70.0000, "estimated_amount": 983, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1054.15, "standard_charge_percentage": 75.0000, "estimated_amount": 1054, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 520.05, "standard_charge_percentage": 37.0000, "estimated_amount": 520, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1054.15, "standard_charge_percentage": 75.0000, "estimated_amount": 1054, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 843.32, "standard_charge_percentage": 60.0000, "estimated_amount": 843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 192.19, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1054.15, "standard_charge_percentage": 75.0000, "estimated_amount": 1054, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1054.15, "standard_charge_percentage": 75.0000, "estimated_amount": 1054, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1124.42, "standard_charge_percentage": 80.0000, "estimated_amount": 1124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 702.76, "standard_charge_percentage": 50.0000, "estimated_amount": 702, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1264.98, "standard_charge_percentage": 90.0000, "estimated_amount": 1264, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1194.7, "standard_charge_percentage": 85.0000, "estimated_amount": 1194, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1124.42, "standard_charge_percentage": 80.0000, "estimated_amount": 1124, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 843.32, "standard_charge_percentage": 60.0000, "estimated_amount": 843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1152.53, "standard_charge_percentage": 82.0000, "estimated_amount": 1152, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 983.26, "estimated_amount": 983, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 283.24, "estimated_amount": 283, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" }]}]} , { "description": "Hc Asp/Drain Large Joint/Bursa", "code_information": [ { "code": "20610", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1722.19, "discounted_cash": 360,"minimum": 251.65,"maximum": 1722.19,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 272.6, "estimated_amount": 272, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1377.75, "standard_charge_percentage": 80.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1549.97, "standard_charge_percentage": 90.0000, "estimated_amount": 1549, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 688.88, "standard_charge_percentage": 40.0000, "estimated_amount": 688, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1377.75, "standard_charge_percentage": 80.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1636.08, "standard_charge_percentage": 95.0000, "estimated_amount": 1636, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1033.31, "standard_charge_percentage": 60.0000, "estimated_amount": 1033, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1377.75, "standard_charge_percentage": 80.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1291.64, "standard_charge_percentage": 75.0000, "estimated_amount": 1291, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 998.87, "standard_charge_percentage": 58.0000, "estimated_amount": 998, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 637.21, "standard_charge_percentage": 37.0000, "estimated_amount": 637, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1377.75, "standard_charge_percentage": 80.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1549.97, "standard_charge_percentage": 90.0000, "estimated_amount": 1549, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 513.73, "estimated_amount": 513, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 257.4, "estimated_amount": 257, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1291.64, "standard_charge_percentage": 75.0000, "estimated_amount": 1291, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1291.64, "standard_charge_percentage": 75.0000, "estimated_amount": 1291, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1506.92, "standard_charge_percentage": 87.5000, "estimated_amount": 1506, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1377.75, "standard_charge_percentage": 80.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1722.19, "standard_charge_percentage": 100.0000, "estimated_amount": 1722, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1205.53, "standard_charge_percentage": 70.0000, "estimated_amount": 1205, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1412.2, "standard_charge_percentage": 82.0000, "estimated_amount": 1412, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 964.43, "standard_charge_percentage": 56.0000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 983.26, "estimated_amount": 983, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 362.38, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1377.75, "standard_charge_percentage": 80.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1549.97, "standard_charge_percentage": 90.0000, "estimated_amount": 1549, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1506.92, "standard_charge_percentage": 87.5000, "estimated_amount": 1506, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1377.75, "standard_charge_percentage": 80.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1377.75, "standard_charge_percentage": 80.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1205.53, "standard_charge_percentage": 70.0000, "estimated_amount": 1205, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1291.64, "standard_charge_percentage": 75.0000, "estimated_amount": 1291, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1549.97, "standard_charge_percentage": 90.0000, "estimated_amount": 1549, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1033.31, "standard_charge_percentage": 60.0000, "estimated_amount": 1033, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 283.24, "estimated_amount": 283, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 364.89, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 359.86, "estimated_amount": 359, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 861.1, "standard_charge_percentage": 50.0000, "estimated_amount": 861, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1549.97, "standard_charge_percentage": 90.0000, "estimated_amount": 1549, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1463.86, "standard_charge_percentage": 85.0000, "estimated_amount": 1463, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1377.75, "standard_charge_percentage": 80.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1722.19, "standard_charge_percentage": 100.0000, "estimated_amount": 1722, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1377.75, "standard_charge_percentage": 80.0000, "estimated_amount": 1377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 516.66, "standard_charge_percentage": 30.0000, "estimated_amount": 516, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1205.53, "standard_charge_percentage": 70.0000, "estimated_amount": 1205, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1687.75, "standard_charge_percentage": 98.0000, "estimated_amount": 1687, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1291.64, "standard_charge_percentage": 75.0000, "estimated_amount": 1291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 374.88, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 555.38, "estimated_amount": 555, "methodology": "fee schedule" }]}]} , { "description": "Hc Arthrocentesis Aspir&/Inj Major Jt/Bursa W/Us", "code_information": [ { "code": "20611", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1639.57, "discounted_cash": 360,"minimum": 142.73,"maximum": 1639.57,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 272.6, "estimated_amount": 272, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 142.73, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1311.66, "standard_charge_percentage": 80.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1475.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1475, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1475.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1475, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1434.62, "standard_charge_percentage": 87.5000, "estimated_amount": 1434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1311.66, "standard_charge_percentage": 80.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1311.66, "standard_charge_percentage": 80.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1639.57, "standard_charge_percentage": 100.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1557.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1557, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1311.66, "standard_charge_percentage": 80.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1229.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1311.66, "standard_charge_percentage": 80.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1229.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 374.88, "estimated_amount": 374, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 555.38, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 364.89, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1639.57, "estimated_amount": 1639, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1229.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1229, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1475.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1475, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1639.57, "standard_charge_percentage": 100.0000, "estimated_amount": 1639, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1311.66, "standard_charge_percentage": 80.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1311.66, "standard_charge_percentage": 80.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 491.87, "standard_charge_percentage": 30.0000, "estimated_amount": 491, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1147.7, "standard_charge_percentage": 70.0000, "estimated_amount": 1147, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1229.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1229, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1344.45, "standard_charge_percentage": 82.0000, "estimated_amount": 1344, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 918.16, "standard_charge_percentage": 56.0000, "estimated_amount": 918, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 606.64, "standard_charge_percentage": 37.0000, "estimated_amount": 606, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1475.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 983.74, "standard_charge_percentage": 60.0000, "estimated_amount": 983, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 983.26, "estimated_amount": 983, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 283.24, "estimated_amount": 283, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 444.3, "estimated_amount": 444, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 359.86, "estimated_amount": 359, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 819.78, "standard_charge_percentage": 50.0000, "estimated_amount": 819, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1393.63, "standard_charge_percentage": 85.0000, "estimated_amount": 1393, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 655.83, "standard_charge_percentage": 40.0000, "estimated_amount": 655, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1311.66, "standard_charge_percentage": 80.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1147.7, "standard_charge_percentage": 70.0000, "estimated_amount": 1147, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 950.95, "standard_charge_percentage": 58.0000, "estimated_amount": 950, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1475.61, "standard_charge_percentage": 90.0000, "estimated_amount": 1475, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 291.57, "estimated_amount": 291, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 388.77, "estimated_amount": 388, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 513.73, "estimated_amount": 513, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 362.38, "estimated_amount": 362, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 142.73, "estimated_amount": 142, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 251.65, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1229.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1311.66, "standard_charge_percentage": 80.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1434.62, "standard_charge_percentage": 87.5000, "estimated_amount": 1434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1311.66, "standard_charge_percentage": 80.0000, "estimated_amount": 1311, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 983.74, "standard_charge_percentage": 60.0000, "estimated_amount": 983, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1147.7, "standard_charge_percentage": 70.0000, "estimated_amount": 1147, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1606.78, "standard_charge_percentage": 98.0000, "estimated_amount": 1606, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 277.69, "estimated_amount": 277, "methodology": "fee schedule" }]}]} , { "description": "Removal of implant deep", "code_information": [ { "code": "20680", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8542.82, "discounted_cash": 3500,"minimum": 920.5,"maximum": 8542.82,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2589.97, "estimated_amount": 2589, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7474.97, "standard_charge_percentage": 87.5000, "estimated_amount": 7474, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8542.82, "standard_charge_percentage": 100.0000, "estimated_amount": 8542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8542.82, "standard_charge_percentage": 100.0000, "estimated_amount": 8542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5125.69, "standard_charge_percentage": 60.0000, "estimated_amount": 5125, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5979.97, "standard_charge_percentage": 70.0000, "estimated_amount": 5979, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7005.11, "standard_charge_percentage": 82.0000, "estimated_amount": 7005, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 920.5, "estimated_amount": 920, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3488.97, "estimated_amount": 3488, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4271.41, "standard_charge_percentage": 50.0000, "estimated_amount": 4271, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3417.13, "standard_charge_percentage": 40.0000, "estimated_amount": 3417, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8115.68, "standard_charge_percentage": 95.0000, "estimated_amount": 8115, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5979.97, "standard_charge_percentage": 70.0000, "estimated_amount": 5979, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4783.98, "standard_charge_percentage": 56.0000, "estimated_amount": 4783, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8371.96, "standard_charge_percentage": 98.0000, "estimated_amount": 8371, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4980.9, "estimated_amount": 4980, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3513.37, "estimated_amount": 3513, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3537.77, "estimated_amount": 3537, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2562.85, "standard_charge_percentage": 30.0000, "estimated_amount": 2562, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5979.97, "standard_charge_percentage": 70.0000, "estimated_amount": 5979, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5125.69, "standard_charge_percentage": 60.0000, "estimated_amount": 5125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2746.23, "estimated_amount": 2746, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7261.4, "standard_charge_percentage": 85.0000, "estimated_amount": 7261, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7474.97, "standard_charge_percentage": 87.5000, "estimated_amount": 7474, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4954.84, "standard_charge_percentage": 58.0000, "estimated_amount": 4954, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 8542.82, "estimated_amount": 8542, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3634.71, "estimated_amount": 3634, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5384.76, "estimated_amount": 5384, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "20985", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 21866.6,"minimum": 1662,"maximum": 21866.6,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 16399.9, "standard_charge_percentage": 75.0000, "estimated_amount": 16399, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 19679.9, "standard_charge_percentage": 90.0000, "estimated_amount": 19679, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 18586.6, "standard_charge_percentage": 85.0000, "estimated_amount": 18586, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 8746.63, "standard_charge_percentage": 40.0000, "estimated_amount": 8746, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 17493.3, "standard_charge_percentage": 80.0000, "estimated_amount": 17493, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6559.97, "standard_charge_percentage": 30.0000, "estimated_amount": 6559, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 15306.6, "standard_charge_percentage": 70.0000, "estimated_amount": 15306, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 8090.63, "standard_charge_percentage": 37.0000, "estimated_amount": 8090, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 21429.2, "standard_charge_percentage": 98.0000, "estimated_amount": 21429, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 17493.3, "standard_charge_percentage": 80.0000, "estimated_amount": 17493, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 16399.9, "standard_charge_percentage": 75.0000, "estimated_amount": 16399, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 17493.3, "standard_charge_percentage": 80.0000, "estimated_amount": 17493, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 20773.2, "standard_charge_percentage": 95.0000, "estimated_amount": 20773, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 13119.9, "standard_charge_percentage": 60.0000, "estimated_amount": 13119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 17493.3, "standard_charge_percentage": 80.0000, "estimated_amount": 17493, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 17493.3, "standard_charge_percentage": 80.0000, "estimated_amount": 17493, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 19679.9, "standard_charge_percentage": 90.0000, "estimated_amount": 19679, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 19679.9, "standard_charge_percentage": 90.0000, "estimated_amount": 19679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 13119.9, "standard_charge_percentage": 60.0000, "estimated_amount": 13119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 17493.3, "standard_charge_percentage": 80.0000, "estimated_amount": 17493, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 19679.9, "standard_charge_percentage": 90.0000, "estimated_amount": 19679, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 19679.9, "standard_charge_percentage": 90.0000, "estimated_amount": 19679, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 19133.3, "standard_charge_percentage": 87.5000, "estimated_amount": 19133, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 17493.3, "standard_charge_percentage": 80.0000, "estimated_amount": 17493, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 16399.9, "standard_charge_percentage": 75.0000, "estimated_amount": 16399, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 15306.6, "standard_charge_percentage": 70.0000, "estimated_amount": 15306, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 16399.9, "standard_charge_percentage": 75.0000, "estimated_amount": 16399, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 17930.6, "standard_charge_percentage": 82.0000, "estimated_amount": 17930, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 12682.6, "standard_charge_percentage": 58.0000, "estimated_amount": 12682, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 10933.3, "standard_charge_percentage": 50.0000, "estimated_amount": 10933, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 19133.3, "standard_charge_percentage": 87.5000, "estimated_amount": 19133, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 17493.3, "standard_charge_percentage": 80.0000, "estimated_amount": 17493, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 21866.6, "standard_charge_percentage": 100.0000, "estimated_amount": 21866, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 21866.6, "standard_charge_percentage": 100.0000, "estimated_amount": 21866, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 17493.3, "standard_charge_percentage": 80.0000, "estimated_amount": 17493, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 17493.3, "standard_charge_percentage": 80.0000, "estimated_amount": 17493, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 15306.6, "standard_charge_percentage": 70.0000, "estimated_amount": 15306, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 12245.3, "standard_charge_percentage": 56.0000, "estimated_amount": 12245, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 16399.9, "standard_charge_percentage": 75.0000, "estimated_amount": 16399, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc Face Tum Deep < 2 Cm", "code_information": [ { "code": "21013", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7592.86, "discounted_cash": 1981,"minimum": 297.12,"maximum": 7592.86,"payers_information":[{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7592.86, "standard_charge_percentage": 100.0000, "estimated_amount": 7592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6226.15, "standard_charge_percentage": 82.0000, "estimated_amount": 6226, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7441, "standard_charge_percentage": 98.0000, "estimated_amount": 7441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7592.86, "standard_charge_percentage": 100.0000, "estimated_amount": 7592, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2277.86, "standard_charge_percentage": 30.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3796.43, "standard_charge_percentage": 50.0000, "estimated_amount": 3796, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6643.75, "standard_charge_percentage": 87.5000, "estimated_amount": 6643, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6643.75, "standard_charge_percentage": 87.5000, "estimated_amount": 6643, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4555.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4555, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4252, "standard_charge_percentage": 56.0000, "estimated_amount": 4252, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 297.12, "estimated_amount": 297, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6453.93, "standard_charge_percentage": 85.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3037.14, "standard_charge_percentage": 40.0000, "estimated_amount": 3037, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7213.22, "standard_charge_percentage": 95.0000, "estimated_amount": 7213, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4403.86, "standard_charge_percentage": 58.0000, "estimated_amount": 4403, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2809.36, "standard_charge_percentage": 37.0000, "estimated_amount": 2809, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4555.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4555, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Nose Xf Wo Stabil", "code_information": [ { "code": "21315", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7548.23, "discounted_cash": 1811,"minimum": 494.04,"maximum": 7548.23,"payers_information":[{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6416, "standard_charge_percentage": 85.0000, "estimated_amount": 6416, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6038.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2264.47, "standard_charge_percentage": 30.0000, "estimated_amount": 2264, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5283.76, "standard_charge_percentage": 70.0000, "estimated_amount": 5283, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5661.17, "standard_charge_percentage": 75.0000, "estimated_amount": 5661, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6189.55, "standard_charge_percentage": 82.0000, "estimated_amount": 6189, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4377.97, "standard_charge_percentage": 58.0000, "estimated_amount": 4377, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6793.41, "standard_charge_percentage": 90.0000, "estimated_amount": 6793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4528.94, "standard_charge_percentage": 60.0000, "estimated_amount": 4528, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1393.46, "estimated_amount": 1393, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1393.46, "estimated_amount": 1393, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 1950.84, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1393.46, "estimated_amount": 1393, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1463.13, "estimated_amount": 1463, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1421.33, "estimated_amount": 1421, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1393.46, "estimated_amount": 1393, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2229.54, "estimated_amount": 2229, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2577.9, "estimated_amount": 2577, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1391.74, "estimated_amount": 1391, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 494.04, "estimated_amount": 494, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1262.77, "estimated_amount": 1262, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1831.02, "estimated_amount": 1831, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5661.17, "standard_charge_percentage": 75.0000, "estimated_amount": 5661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6038.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3774.11, "standard_charge_percentage": 50.0000, "estimated_amount": 3774, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6793.41, "standard_charge_percentage": 90.0000, "estimated_amount": 6793, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6038.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6038.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6038, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6038.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5661.17, "standard_charge_percentage": 75.0000, "estimated_amount": 5661, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4227.01, "standard_charge_percentage": 56.0000, "estimated_amount": 4227, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2792.85, "standard_charge_percentage": 37.0000, "estimated_amount": 2792, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6038.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1393.46, "estimated_amount": 1393, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1881.17, "estimated_amount": 1881, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1393.46, "estimated_amount": 1393, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1818.39, "estimated_amount": 1818, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6793.41, "standard_charge_percentage": 90.0000, "estimated_amount": 6793, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3019.29, "standard_charge_percentage": 40.0000, "estimated_amount": 3019, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6604.7, "standard_charge_percentage": 87.5000, "estimated_amount": 6604, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6038.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6038, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6038.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6038, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7548.23, "standard_charge_percentage": 100.0000, "estimated_amount": 7548, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4528.94, "standard_charge_percentage": 60.0000, "estimated_amount": 4528, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6038.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6038, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5283.76, "standard_charge_percentage": 70.0000, "estimated_amount": 5283, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6793.41, "standard_charge_percentage": 90.0000, "estimated_amount": 6793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1393.46, "estimated_amount": 1393, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 4934.06, "estimated_amount": 4934, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1393.46, "estimated_amount": 1393, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2229.54, "estimated_amount": 2229, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1393.46, "estimated_amount": 1393, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1262.77, "estimated_amount": 1262, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1805.76, "estimated_amount": 1805, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5661.17, "standard_charge_percentage": 75.0000, "estimated_amount": 5661, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6038.58, "standard_charge_percentage": 80.0000, "estimated_amount": 6038, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6793.41, "standard_charge_percentage": 90.0000, "estimated_amount": 6793, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6604.7, "standard_charge_percentage": 87.5000, "estimated_amount": 6604, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7548.23, "standard_charge_percentage": 100.0000, "estimated_amount": 7548, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7170.82, "standard_charge_percentage": 95.0000, "estimated_amount": 7170, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5283.76, "standard_charge_percentage": 70.0000, "estimated_amount": 5283, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7397.27, "standard_charge_percentage": 98.0000, "estimated_amount": 7397, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5661.17, "standard_charge_percentage": 75.0000, "estimated_amount": 5661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1393.46, "estimated_amount": 1393, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1463.13, "estimated_amount": 1463, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 1950.84, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2786.92, "estimated_amount": 2786, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Temporomandibl Disloc", "code_information": [ { "code": "21480", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" }]}]} , { "description": "Hc Biopsy Soft Tissue Neck/Chest", "code_information": [ { "code": "21550", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8071.7, "discounted_cash": 1981,"minimum": 525.22,"maximum": 8071.7,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3228.68, "standard_charge_percentage": 40.0000, "estimated_amount": 3228, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4843.02, "standard_charge_percentage": 60.0000, "estimated_amount": 4843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2986.53, "standard_charge_percentage": 37.0000, "estimated_amount": 2986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6053.77, "standard_charge_percentage": 75.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6053.77, "standard_charge_percentage": 75.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4035.85, "standard_charge_percentage": 50.0000, "estimated_amount": 4035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8071.7, "standard_charge_percentage": 100.0000, "estimated_amount": 8071, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8071.7, "standard_charge_percentage": 100.0000, "estimated_amount": 8071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6053.77, "standard_charge_percentage": 75.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4681.59, "standard_charge_percentage": 58.0000, "estimated_amount": 4681, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7264.53, "standard_charge_percentage": 90.0000, "estimated_amount": 7264, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6053.77, "standard_charge_percentage": 75.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7264.53, "standard_charge_percentage": 90.0000, "estimated_amount": 7264, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7264.53, "standard_charge_percentage": 90.0000, "estimated_amount": 7264, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6860.94, "standard_charge_percentage": 85.0000, "estimated_amount": 6860, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7062.74, "standard_charge_percentage": 87.5000, "estimated_amount": 7062, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5650.19, "standard_charge_percentage": 70.0000, "estimated_amount": 5650, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4843.02, "standard_charge_percentage": 60.0000, "estimated_amount": 4843, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7264.53, "standard_charge_percentage": 90.0000, "estimated_amount": 7264, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7062.74, "standard_charge_percentage": 87.5000, "estimated_amount": 7062, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7668.11, "standard_charge_percentage": 95.0000, "estimated_amount": 7668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2421.51, "standard_charge_percentage": 30.0000, "estimated_amount": 2421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6053.77, "standard_charge_percentage": 75.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5650.19, "standard_charge_percentage": 70.0000, "estimated_amount": 5650, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5650.19, "standard_charge_percentage": 70.0000, "estimated_amount": 5650, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6618.79, "standard_charge_percentage": 82.0000, "estimated_amount": 6618, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4520.15, "standard_charge_percentage": 56.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7264.53, "standard_charge_percentage": 90.0000, "estimated_amount": 7264, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7910.27, "standard_charge_percentage": 98.0000, "estimated_amount": 7910, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "Exc Neck Les Sc 3 Cm/>", "code_information": [ { "code": "21552", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 16032.3, "discounted_cash": 3500,"minimum": 847.14,"maximum": 16032.3,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 847.14, "estimated_amount": 847, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3488.97, "estimated_amount": 3488, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12825.8, "standard_charge_percentage": 80.0000, "estimated_amount": 12825, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 13627.5, "standard_charge_percentage": 85.0000, "estimated_amount": 13627, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 12825.8, "standard_charge_percentage": 80.0000, "estimated_amount": 12825, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 12825.8, "standard_charge_percentage": 80.0000, "estimated_amount": 12825, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 12024.2, "standard_charge_percentage": 75.0000, "estimated_amount": 12024, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 5931.95, "standard_charge_percentage": 37.0000, "estimated_amount": 5931, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 12024.2, "standard_charge_percentage": 75.0000, "estimated_amount": 12024, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9533.36, "estimated_amount": 9533, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5384.76, "estimated_amount": 5384, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2589.97, "estimated_amount": 2589, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 12825.8, "standard_charge_percentage": 80.0000, "estimated_amount": 12825, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 12024.2, "standard_charge_percentage": 75.0000, "estimated_amount": 12024, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 14028.3, "standard_charge_percentage": 87.5000, "estimated_amount": 14028, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 14028.3, "standard_charge_percentage": 87.5000, "estimated_amount": 14028, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 15230.7, "standard_charge_percentage": 95.0000, "estimated_amount": 15230, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 16032.3, "standard_charge_percentage": 100.0000, "estimated_amount": 16032, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 12825.8, "standard_charge_percentage": 80.0000, "estimated_amount": 12825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4809.69, "standard_charge_percentage": 30.0000, "estimated_amount": 4809, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 11222.6, "standard_charge_percentage": 70.0000, "estimated_amount": 11222, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 11222.6, "standard_charge_percentage": 70.0000, "estimated_amount": 11222, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 14429.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14429, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 14429.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14429, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3634.71, "estimated_amount": 3634, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 14429.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14429, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 14429.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14429, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 14429.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14429, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6412.92, "standard_charge_percentage": 40.0000, "estimated_amount": 6412, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 16032.3, "standard_charge_percentage": 100.0000, "estimated_amount": 16032, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 9619.38, "standard_charge_percentage": 60.0000, "estimated_amount": 9619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12825.8, "standard_charge_percentage": 80.0000, "estimated_amount": 12825, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 12825.8, "standard_charge_percentage": 80.0000, "estimated_amount": 12825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 12024.2, "standard_charge_percentage": 75.0000, "estimated_amount": 12024, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 11222.6, "standard_charge_percentage": 70.0000, "estimated_amount": 11222, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 13146.5, "standard_charge_percentage": 82.0000, "estimated_amount": 13146, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9298.73, "standard_charge_percentage": 58.0000, "estimated_amount": 9298, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2746.23, "estimated_amount": 2746, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4980.9, "estimated_amount": 4980, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3513.37, "estimated_amount": 3513, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3537.77, "estimated_amount": 3537, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 12024.2, "standard_charge_percentage": 75.0000, "estimated_amount": 12024, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 8016.15, "standard_charge_percentage": 50.0000, "estimated_amount": 8016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 12825.8, "standard_charge_percentage": 80.0000, "estimated_amount": 12825, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 12825.8, "standard_charge_percentage": 80.0000, "estimated_amount": 12825, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8978.09, "standard_charge_percentage": 56.0000, "estimated_amount": 8978, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12825.8, "standard_charge_percentage": 80.0000, "estimated_amount": 12825, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 15711.7, "standard_charge_percentage": 98.0000, "estimated_amount": 15711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 9619.38, "standard_charge_percentage": 60.0000, "estimated_amount": 9619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" }]}]} , { "description": "Exc Back Les Sc < 3 Cm", "code_information": [ { "code": "21930", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9280.75, "discounted_cash": 1981,"minimum": 525.22,"maximum": 9280.75,"payers_information":[{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4640.38, "standard_charge_percentage": 50.0000, "estimated_amount": 4640, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3712.3, "standard_charge_percentage": 40.0000, "estimated_amount": 3712, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8120.66, "standard_charge_percentage": 87.5000, "estimated_amount": 8120, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8120.66, "standard_charge_percentage": 87.5000, "estimated_amount": 8120, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9280.75, "standard_charge_percentage": 100.0000, "estimated_amount": 9280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2784.22, "standard_charge_percentage": 30.0000, "estimated_amount": 2784, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6960.56, "standard_charge_percentage": 75.0000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5382.84, "standard_charge_percentage": 58.0000, "estimated_amount": 5382, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8352.67, "standard_charge_percentage": 90.0000, "estimated_amount": 8352, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9095.14, "standard_charge_percentage": 98.0000, "estimated_amount": 9095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8352.67, "standard_charge_percentage": 90.0000, "estimated_amount": 8352, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6960.56, "standard_charge_percentage": 75.0000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6496.52, "standard_charge_percentage": 70.0000, "estimated_amount": 6496, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6496.52, "standard_charge_percentage": 70.0000, "estimated_amount": 6496, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6496.52, "standard_charge_percentage": 70.0000, "estimated_amount": 6496, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6960.56, "standard_charge_percentage": 75.0000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5568.45, "standard_charge_percentage": 60.0000, "estimated_amount": 5568, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8352.67, "standard_charge_percentage": 90.0000, "estimated_amount": 8352, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8352.67, "standard_charge_percentage": 90.0000, "estimated_amount": 8352, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7888.64, "standard_charge_percentage": 85.0000, "estimated_amount": 7888, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8816.71, "standard_charge_percentage": 95.0000, "estimated_amount": 8816, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7610.22, "standard_charge_percentage": 82.0000, "estimated_amount": 7610, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5197.22, "standard_charge_percentage": 56.0000, "estimated_amount": 5197, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6960.56, "standard_charge_percentage": 75.0000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6960.56, "standard_charge_percentage": 75.0000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9280.75, "standard_charge_percentage": 100.0000, "estimated_amount": 9280, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5568.45, "standard_charge_percentage": 60.0000, "estimated_amount": 5568, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7424.6, "standard_charge_percentage": 80.0000, "estimated_amount": 7424, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8352.67, "standard_charge_percentage": 90.0000, "estimated_amount": 8352, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Cervicothoracic Inj", "code_information": [ { "code": "22510", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9652.77, "discounted_cash": 3967,"minimum": 1758.35,"maximum": 9652.77,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8687.49, "standard_charge_percentage": 90.0000, "estimated_amount": 8687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9652.77, "standard_charge_percentage": 100.0000, "estimated_amount": 9652, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5791.66, "standard_charge_percentage": 60.0000, "estimated_amount": 5791, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7239.58, "standard_charge_percentage": 75.0000, "estimated_amount": 7239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5791.66, "standard_charge_percentage": 60.0000, "estimated_amount": 5791, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4826.39, "standard_charge_percentage": 50.0000, "estimated_amount": 4826, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3861.11, "standard_charge_percentage": 40.0000, "estimated_amount": 3861, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8446.17, "standard_charge_percentage": 87.5000, "estimated_amount": 8446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5405.55, "standard_charge_percentage": 56.0000, "estimated_amount": 5405, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5598.61, "standard_charge_percentage": 58.0000, "estimated_amount": 5598, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8687.49, "standard_charge_percentage": 90.0000, "estimated_amount": 8687, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9652.77, "estimated_amount": 9652, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 1758.35, "estimated_amount": 1758, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1758.35, "estimated_amount": 1758, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7239.58, "standard_charge_percentage": 75.0000, "estimated_amount": 7239, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7239.58, "standard_charge_percentage": 75.0000, "estimated_amount": 7239, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9652.77, "standard_charge_percentage": 100.0000, "estimated_amount": 9652, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 9170.13, "standard_charge_percentage": 95.0000, "estimated_amount": 9170, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2895.83, "standard_charge_percentage": 30.0000, "estimated_amount": 2895, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6756.94, "standard_charge_percentage": 70.0000, "estimated_amount": 6756, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7239.58, "standard_charge_percentage": 75.0000, "estimated_amount": 7239, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7915.27, "standard_charge_percentage": 82.0000, "estimated_amount": 7915, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8687.49, "standard_charge_percentage": 90.0000, "estimated_amount": 8687, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9459.71, "standard_charge_percentage": 98.0000, "estimated_amount": 9459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8687.49, "standard_charge_percentage": 90.0000, "estimated_amount": 8687, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8687.49, "standard_charge_percentage": 90.0000, "estimated_amount": 8687, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 8204.85, "standard_charge_percentage": 85.0000, "estimated_amount": 8204, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8446.17, "standard_charge_percentage": 87.5000, "estimated_amount": 8446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7239.58, "standard_charge_percentage": 75.0000, "estimated_amount": 7239, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6756.94, "standard_charge_percentage": 70.0000, "estimated_amount": 6756, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6756.94, "standard_charge_percentage": 70.0000, "estimated_amount": 6756, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3571.52, "standard_charge_percentage": 37.0000, "estimated_amount": 3571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Lumbosacral Inj", "code_information": [ { "code": "22511", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9652.77, "discounted_cash": 3967,"minimum": 1758.35,"maximum": 9652.77,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 1758.35, "estimated_amount": 1758, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1758.35, "estimated_amount": 1758, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8687.49, "standard_charge_percentage": 90.0000, "estimated_amount": 8687, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9652.77, "standard_charge_percentage": 100.0000, "estimated_amount": 9652, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2895.83, "standard_charge_percentage": 30.0000, "estimated_amount": 2895, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6756.94, "standard_charge_percentage": 70.0000, "estimated_amount": 6756, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6756.94, "standard_charge_percentage": 70.0000, "estimated_amount": 6756, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7915.27, "standard_charge_percentage": 82.0000, "estimated_amount": 7915, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3571.52, "standard_charge_percentage": 37.0000, "estimated_amount": 3571, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7239.58, "standard_charge_percentage": 75.0000, "estimated_amount": 7239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4826.39, "standard_charge_percentage": 50.0000, "estimated_amount": 4826, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8687.49, "standard_charge_percentage": 90.0000, "estimated_amount": 8687, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3861.11, "standard_charge_percentage": 40.0000, "estimated_amount": 3861, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8446.17, "standard_charge_percentage": 87.5000, "estimated_amount": 8446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 9170.13, "standard_charge_percentage": 95.0000, "estimated_amount": 9170, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5791.66, "standard_charge_percentage": 60.0000, "estimated_amount": 5791, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7239.58, "standard_charge_percentage": 75.0000, "estimated_amount": 7239, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5405.55, "standard_charge_percentage": 56.0000, "estimated_amount": 5405, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9459.71, "standard_charge_percentage": 98.0000, "estimated_amount": 9459, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7239.58, "standard_charge_percentage": 75.0000, "estimated_amount": 7239, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7239.58, "standard_charge_percentage": 75.0000, "estimated_amount": 7239, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8687.49, "standard_charge_percentage": 90.0000, "estimated_amount": 8687, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8687.49, "standard_charge_percentage": 90.0000, "estimated_amount": 8687, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 8204.85, "standard_charge_percentage": 85.0000, "estimated_amount": 8204, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8446.17, "standard_charge_percentage": 87.5000, "estimated_amount": 8446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9652.77, "standard_charge_percentage": 100.0000, "estimated_amount": 9652, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7239.58, "standard_charge_percentage": 75.0000, "estimated_amount": 7239, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6756.94, "standard_charge_percentage": 70.0000, "estimated_amount": 6756, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5598.61, "standard_charge_percentage": 58.0000, "estimated_amount": 5598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7722.22, "standard_charge_percentage": 80.0000, "estimated_amount": 7722, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8687.49, "standard_charge_percentage": 90.0000, "estimated_amount": 8687, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5791.66, "standard_charge_percentage": 60.0000, "estimated_amount": 5791, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9652.77, "estimated_amount": 9652, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Vertebroplasty Addl Inj", "code_information": [ { "code": "22512", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2310.78,"minimum": 693.23,"maximum": 2310.78,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2079.7, "standard_charge_percentage": 90.0000, "estimated_amount": 2079, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1848.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1386.47, "standard_charge_percentage": 60.0000, "estimated_amount": 1386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1848.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1733.09, "standard_charge_percentage": 75.0000, "estimated_amount": 1733, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1617.55, "standard_charge_percentage": 70.0000, "estimated_amount": 1617, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1294.04, "standard_charge_percentage": 56.0000, "estimated_amount": 1294, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1964.16, "standard_charge_percentage": 85.0000, "estimated_amount": 1964, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1848.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2195.24, "standard_charge_percentage": 95.0000, "estimated_amount": 2195, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2310.78, "standard_charge_percentage": 100.0000, "estimated_amount": 2310, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1733.09, "standard_charge_percentage": 75.0000, "estimated_amount": 1733, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2079.7, "standard_charge_percentage": 90.0000, "estimated_amount": 2079, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1848.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1733.09, "standard_charge_percentage": 75.0000, "estimated_amount": 1733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1848.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1155.39, "standard_charge_percentage": 50.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2079.7, "standard_charge_percentage": 90.0000, "estimated_amount": 2079, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 924.31, "standard_charge_percentage": 40.0000, "estimated_amount": 924, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2021.93, "standard_charge_percentage": 87.5000, "estimated_amount": 2021, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2310.78, "standard_charge_percentage": 100.0000, "estimated_amount": 2310, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1617.55, "standard_charge_percentage": 70.0000, "estimated_amount": 1617, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1894.84, "standard_charge_percentage": 82.0000, "estimated_amount": 1894, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 854.99, "standard_charge_percentage": 37.0000, "estimated_amount": 854, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1848.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2079.7, "standard_charge_percentage": 90.0000, "estimated_amount": 2079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1733.09, "standard_charge_percentage": 75.0000, "estimated_amount": 1733, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2079.7, "standard_charge_percentage": 90.0000, "estimated_amount": 2079, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2021.93, "standard_charge_percentage": 87.5000, "estimated_amount": 2021, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1848.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1848.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1848.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1848.62, "standard_charge_percentage": 80.0000, "estimated_amount": 1848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 693.23, "standard_charge_percentage": 30.0000, "estimated_amount": 693, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1617.55, "standard_charge_percentage": 70.0000, "estimated_amount": 1617, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1340.25, "standard_charge_percentage": 58.0000, "estimated_amount": 1340, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2264.56, "standard_charge_percentage": 98.0000, "estimated_amount": 2264, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1733.09, "standard_charge_percentage": 75.0000, "estimated_amount": 1733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1386.47, "standard_charge_percentage": 60.0000, "estimated_amount": 1386, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Perq Vertebral Augmentation, Thoracic", "code_information": [ { "code": "22513", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 20456.3, "discounted_cash": 8736,"minimum": 4272.54,"maximum": 20456.3,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4272.54, "estimated_amount": 4272, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 18410.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18410, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 19433.5, "standard_charge_percentage": 95.0000, "estimated_amount": 19433, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 12273.8, "standard_charge_percentage": 60.0000, "estimated_amount": 12273, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 15342.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15342, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 15342.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15342, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 11455.5, "standard_charge_percentage": 56.0000, "estimated_amount": 11455, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 18410.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 12273.8, "standard_charge_percentage": 60.0000, "estimated_amount": 12273, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 15342.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15342, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 17387.8, "standard_charge_percentage": 85.0000, "estimated_amount": 17387, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 20456.3, "standard_charge_percentage": 100.0000, "estimated_amount": 20456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 16774.2, "standard_charge_percentage": 82.0000, "estimated_amount": 16774, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 11864.7, "standard_charge_percentage": 58.0000, "estimated_amount": 11864, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 20047.2, "standard_charge_percentage": 98.0000, "estimated_amount": 20047, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13440.5, "estimated_amount": 13440, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 10228.2, "standard_charge_percentage": 50.0000, "estimated_amount": 10228, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 18410.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18410, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 18410.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18410, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 8182.52, "standard_charge_percentage": 40.0000, "estimated_amount": 8182, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 17899.3, "standard_charge_percentage": 87.5000, "estimated_amount": 17899, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 14319.4, "standard_charge_percentage": 70.0000, "estimated_amount": 14319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 20456.3, "estimated_amount": 20456, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 4272.54, "estimated_amount": 4272, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4489, "estimated_amount": 4489, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 15342.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15342, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 17899.3, "standard_charge_percentage": 87.5000, "estimated_amount": 17899, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 20456.3, "standard_charge_percentage": 100.0000, "estimated_amount": 20456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6136.89, "standard_charge_percentage": 30.0000, "estimated_amount": 6136, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 14319.4, "standard_charge_percentage": 70.0000, "estimated_amount": 14319, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 14319.4, "standard_charge_percentage": 70.0000, "estimated_amount": 14319, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 7568.83, "standard_charge_percentage": 37.0000, "estimated_amount": 7568, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 18410.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18410, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 15342.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15342, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Vertebral Augmentation, Lumbar", "code_information": [ { "code": "22514", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 20456.3, "discounted_cash": 8736,"minimum": 4272.54,"maximum": 20456.3,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 15342.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 17387.8, "standard_charge_percentage": 85.0000, "estimated_amount": 17387, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 20456.3, "standard_charge_percentage": 100.0000, "estimated_amount": 20456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 16774.2, "standard_charge_percentage": 82.0000, "estimated_amount": 16774, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 11864.7, "standard_charge_percentage": 58.0000, "estimated_amount": 11864, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 20456.3, "estimated_amount": 20456, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 15342.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15342, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 10228.2, "standard_charge_percentage": 50.0000, "estimated_amount": 10228, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 8182.52, "standard_charge_percentage": 40.0000, "estimated_amount": 8182, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 17899.3, "standard_charge_percentage": 87.5000, "estimated_amount": 17899, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 19433.5, "standard_charge_percentage": 95.0000, "estimated_amount": 19433, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 12273.8, "standard_charge_percentage": 60.0000, "estimated_amount": 12273, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 18410.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 12273.8, "standard_charge_percentage": 60.0000, "estimated_amount": 12273, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 4272.54, "estimated_amount": 4272, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4489, "estimated_amount": 4489, "methodology": "case rate" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 17899.3, "standard_charge_percentage": 87.5000, "estimated_amount": 17899, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 20456.3, "standard_charge_percentage": 100.0000, "estimated_amount": 20456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6136.89, "standard_charge_percentage": 30.0000, "estimated_amount": 6136, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 15342.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15342, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 14319.4, "standard_charge_percentage": 70.0000, "estimated_amount": 14319, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 14319.4, "standard_charge_percentage": 70.0000, "estimated_amount": 14319, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 11455.5, "standard_charge_percentage": 56.0000, "estimated_amount": 11455, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 7568.83, "standard_charge_percentage": 37.0000, "estimated_amount": 7568, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 15342.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4272.54, "estimated_amount": 4272, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 18410.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18410, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 18410.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18410, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 18410.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18410, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 16365, "standard_charge_percentage": 80.0000, "estimated_amount": 16365, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 14319.4, "standard_charge_percentage": 70.0000, "estimated_amount": 14319, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 15342.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15342, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 18410.7, "standard_charge_percentage": 90.0000, "estimated_amount": 18410, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 20047.2, "standard_charge_percentage": 98.0000, "estimated_amount": 20047, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13440.5, "estimated_amount": 13440, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Vertebral Augmentation Add, Thora Or Lumb", "code_information": [ { "code": "22515", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6715.52,"minimum": 1662,"maximum": 6715.52,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6043.97, "standard_charge_percentage": 90.0000, "estimated_amount": 6043, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5708.19, "standard_charge_percentage": 85.0000, "estimated_amount": 5708, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2686.21, "standard_charge_percentage": 40.0000, "estimated_amount": 2686, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5372.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5372.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4700.86, "standard_charge_percentage": 70.0000, "estimated_amount": 4700, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 5506.73, "standard_charge_percentage": 82.0000, "estimated_amount": 5506, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3760.69, "standard_charge_percentage": 56.0000, "estimated_amount": 3760, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3895, "standard_charge_percentage": 58.0000, "estimated_amount": 3895, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5372.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5036.64, "standard_charge_percentage": 75.0000, "estimated_amount": 5036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4029.31, "standard_charge_percentage": 60.0000, "estimated_amount": 4029, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5036.64, "standard_charge_percentage": 75.0000, "estimated_amount": 5036, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5372.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5372.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4029.31, "standard_charge_percentage": 60.0000, "estimated_amount": 4029, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5036.64, "standard_charge_percentage": 75.0000, "estimated_amount": 5036, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 6581.21, "standard_charge_percentage": 98.0000, "estimated_amount": 6581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5036.64, "standard_charge_percentage": 75.0000, "estimated_amount": 5036, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6043.97, "standard_charge_percentage": 90.0000, "estimated_amount": 6043, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5876.08, "standard_charge_percentage": 87.5000, "estimated_amount": 5876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 6379.74, "standard_charge_percentage": 95.0000, "estimated_amount": 6379, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 6715.52, "standard_charge_percentage": 100.0000, "estimated_amount": 6715, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5372.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2014.66, "standard_charge_percentage": 30.0000, "estimated_amount": 2014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5036.64, "standard_charge_percentage": 75.0000, "estimated_amount": 5036, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4700.86, "standard_charge_percentage": 70.0000, "estimated_amount": 4700, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2484.74, "standard_charge_percentage": 37.0000, "estimated_amount": 2484, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6043.97, "standard_charge_percentage": 90.0000, "estimated_amount": 6043, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5372.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3357.76, "standard_charge_percentage": 50.0000, "estimated_amount": 3357, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6043.97, "standard_charge_percentage": 90.0000, "estimated_amount": 6043, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5876.08, "standard_charge_percentage": 87.5000, "estimated_amount": 5876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 6715.52, "standard_charge_percentage": 100.0000, "estimated_amount": 6715, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5372.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5372.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5372.42, "standard_charge_percentage": 80.0000, "estimated_amount": 5372, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4700.86, "standard_charge_percentage": 70.0000, "estimated_amount": 4700, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6043.97, "standard_charge_percentage": 90.0000, "estimated_amount": 6043, "methodology": "percent of total billed charges" }]}]} , { "description": "Exc abdl tum deep < 5 cm", "code_information": [ { "code": "22900", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8542.82, "discounted_cash": 3500,"minimum": 920.5,"maximum": 8542.82,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7474.97, "standard_charge_percentage": 87.5000, "estimated_amount": 7474, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7474.97, "standard_charge_percentage": 87.5000, "estimated_amount": 7474, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8542.82, "standard_charge_percentage": 100.0000, "estimated_amount": 8542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2562.85, "standard_charge_percentage": 30.0000, "estimated_amount": 2562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5979.97, "standard_charge_percentage": 70.0000, "estimated_amount": 5979, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7005.11, "standard_charge_percentage": 82.0000, "estimated_amount": 7005, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3634.71, "estimated_amount": 3634, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4271.41, "standard_charge_percentage": 50.0000, "estimated_amount": 4271, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8115.68, "standard_charge_percentage": 95.0000, "estimated_amount": 8115, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5979.97, "standard_charge_percentage": 70.0000, "estimated_amount": 5979, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8371.96, "standard_charge_percentage": 98.0000, "estimated_amount": 8371, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4980.9, "estimated_amount": 4980, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5384.76, "estimated_amount": 5384, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3513.37, "estimated_amount": 3513, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 920.5, "estimated_amount": 920, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3537.77, "estimated_amount": 3537, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3488.97, "estimated_amount": 3488, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5979.97, "standard_charge_percentage": 70.0000, "estimated_amount": 5979, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4783.98, "standard_charge_percentage": 56.0000, "estimated_amount": 4783, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5125.69, "standard_charge_percentage": 60.0000, "estimated_amount": 5125, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2746.23, "estimated_amount": 2746, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2589.97, "estimated_amount": 2589, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1403, "estimated_amount": 1403, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7261.4, "standard_charge_percentage": 85.0000, "estimated_amount": 7261, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3417.13, "standard_charge_percentage": 40.0000, "estimated_amount": 3417, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8542.82, "standard_charge_percentage": 100.0000, "estimated_amount": 8542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5125.69, "standard_charge_percentage": 60.0000, "estimated_amount": 5125, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4954.84, "standard_charge_percentage": 58.0000, "estimated_amount": 4954, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 8542.82, "estimated_amount": 8542, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" }]}]} , { "description": "Exc abd les sc < 3 cm", "code_information": [ { "code": "22902", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7592.86, "discounted_cash": 1981,"minimum": 633.79,"maximum": 7592.86,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 633.79, "estimated_amount": 633, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7592.86, "standard_charge_percentage": 100.0000, "estimated_amount": 7592, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4252, "standard_charge_percentage": 56.0000, "estimated_amount": 4252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7213.22, "standard_charge_percentage": 95.0000, "estimated_amount": 7213, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4555.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4555, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6226.15, "standard_charge_percentage": 82.0000, "estimated_amount": 6226, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4403.86, "standard_charge_percentage": 58.0000, "estimated_amount": 4403, "methodology": "percent of total billed charges" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3796.43, "standard_charge_percentage": 50.0000, "estimated_amount": 3796, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6643.75, "standard_charge_percentage": 87.5000, "estimated_amount": 6643, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6643.75, "standard_charge_percentage": 87.5000, "estimated_amount": 6643, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7441, "standard_charge_percentage": 98.0000, "estimated_amount": 7441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6453.93, "standard_charge_percentage": 85.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3037.14, "standard_charge_percentage": 40.0000, "estimated_amount": 3037, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7592.86, "standard_charge_percentage": 100.0000, "estimated_amount": 7592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2277.86, "standard_charge_percentage": 30.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2809.36, "standard_charge_percentage": 37.0000, "estimated_amount": 2809, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4555.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4555, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "Hc Inj Proc Shoulder Arthrography/Ct/Mri", "code_information": [ { "code": "23350", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1302.26,"minimum": 208,"maximum": 1302.26,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 520.9, "standard_charge_percentage": 40.0000, "estimated_amount": 520, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1139.48, "standard_charge_percentage": 87.5000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1237.15, "standard_charge_percentage": 95.0000, "estimated_amount": 1237, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 390.68, "standard_charge_percentage": 30.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1276.21, "standard_charge_percentage": 98.0000, "estimated_amount": 1276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1302.26, "estimated_amount": 1302, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1139.48, "standard_charge_percentage": 87.5000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1302.26, "standard_charge_percentage": 100.0000, "estimated_amount": 1302, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1302.26, "standard_charge_percentage": 100.0000, "estimated_amount": 1302, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 781.36, "standard_charge_percentage": 60.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 729.27, "standard_charge_percentage": 56.0000, "estimated_amount": 729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1067.85, "standard_charge_percentage": 82.0000, "estimated_amount": 1067, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 481.84, "standard_charge_percentage": 37.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 781.36, "standard_charge_percentage": 60.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 651.13, "standard_charge_percentage": 50.0000, "estimated_amount": 651, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1106.92, "standard_charge_percentage": 85.0000, "estimated_amount": 1106, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 755.31, "standard_charge_percentage": 58.0000, "estimated_amount": 755, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "23430", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4431.55, "discounted_cash": 8736,"minimum": 1329.46,"maximum": 4431.55,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2215.78, "standard_charge_percentage": 50.0000, "estimated_amount": 2215, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3988.39, "standard_charge_percentage": 90.0000, "estimated_amount": 3988, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3988.39, "standard_charge_percentage": 90.0000, "estimated_amount": 3988, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3877.61, "standard_charge_percentage": 87.5000, "estimated_amount": 3877, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3545.24, "standard_charge_percentage": 80.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 4209.97, "standard_charge_percentage": 95.0000, "estimated_amount": 4209, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3545.24, "standard_charge_percentage": 80.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3102.09, "standard_charge_percentage": 70.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3102.09, "standard_charge_percentage": 70.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3323.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3323, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3633.87, "standard_charge_percentage": 82.0000, "estimated_amount": 3633, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3323.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3323, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3766.82, "standard_charge_percentage": 85.0000, "estimated_amount": 3766, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3545.24, "standard_charge_percentage": 80.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3102.09, "standard_charge_percentage": 70.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3988.39, "standard_charge_percentage": 90.0000, "estimated_amount": 3988, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 4342.92, "standard_charge_percentage": 98.0000, "estimated_amount": 4342, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2658.93, "standard_charge_percentage": 60.0000, "estimated_amount": 2658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3323.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3323, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3545.24, "standard_charge_percentage": 80.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3988.39, "standard_charge_percentage": 90.0000, "estimated_amount": 3988, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1772.62, "standard_charge_percentage": 40.0000, "estimated_amount": 1772, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3545.24, "standard_charge_percentage": 80.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 4431.55, "standard_charge_percentage": 100.0000, "estimated_amount": 4431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3545.24, "standard_charge_percentage": 80.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3545.24, "standard_charge_percentage": 80.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2481.67, "standard_charge_percentage": 56.0000, "estimated_amount": 2481, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3988.39, "standard_charge_percentage": 90.0000, "estimated_amount": 3988, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1403, "estimated_amount": 1403, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3545.24, "standard_charge_percentage": 80.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3877.61, "standard_charge_percentage": 87.5000, "estimated_amount": 3877, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3545.24, "standard_charge_percentage": 80.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 4431.55, "standard_charge_percentage": 100.0000, "estimated_amount": 4431, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2658.93, "standard_charge_percentage": 60.0000, "estimated_amount": 2658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1329.46, "standard_charge_percentage": 30.0000, "estimated_amount": 1329, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3323.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3323, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2570.3, "standard_charge_percentage": 58.0000, "estimated_amount": 2570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3545.24, "standard_charge_percentage": 80.0000, "estimated_amount": 3545, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3323.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3323, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 4431.55, "estimated_amount": 4431, "methodology": "fee schedule" }]}]} , { "description": "Reconstruct Shoulder Joint", "code_information": [ { "code": "23472", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 20184.2, "discounted_cash": 22489,"minimum": 4489,"maximum": 20184.2,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16147.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 10092.1, "standard_charge_percentage": 50.0000, "estimated_amount": 10092, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 18165.8, "standard_charge_percentage": 90.0000, "estimated_amount": 18165, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 16147.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16147, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 20184.2, "standard_charge_percentage": 100.0000, "estimated_amount": 20184, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 19175, "standard_charge_percentage": 95.0000, "estimated_amount": 19174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16147.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16147, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 16147.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 15138.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15138, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 14128.9, "standard_charge_percentage": 70.0000, "estimated_amount": 14128, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 18165.8, "standard_charge_percentage": 90.0000, "estimated_amount": 18165, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 19780.5, "standard_charge_percentage": 98.0000, "estimated_amount": 19780, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 17299.9, "estimated_amount": 17299, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 17299.9, "estimated_amount": 17299, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 17299.9, "estimated_amount": 17299, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 18164.9, "estimated_amount": 18164, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 8805.05, "estimated_amount": 8805, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 15677.2, "estimated_amount": 15677, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4489, "estimated_amount": 4489, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 15138.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15138, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 20184.2, "standard_charge_percentage": 100.0000, "estimated_amount": 20184, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 15138.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15138, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 16551, "standard_charge_percentage": 82.0000, "estimated_amount": 16551, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 17299.9, "estimated_amount": 17299, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 17299.9, "estimated_amount": 17299, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 18164.9, "estimated_amount": 18164, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 17299.9, "estimated_amount": 17299, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 15677.2, "estimated_amount": 15677, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 15138.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15138, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 16147.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16147, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 18165.8, "standard_charge_percentage": 90.0000, "estimated_amount": 18165, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 17156.6, "standard_charge_percentage": 85.0000, "estimated_amount": 17156, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 8073.68, "standard_charge_percentage": 40.0000, "estimated_amount": 8073, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 17661.2, "standard_charge_percentage": 87.5000, "estimated_amount": 17661, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 16147.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16147, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 12110.5, "standard_charge_percentage": 60.0000, "estimated_amount": 12110, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 14128.9, "standard_charge_percentage": 70.0000, "estimated_amount": 14128, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 11706.8, "standard_charge_percentage": 58.0000, "estimated_amount": 11706, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 18165.8, "standard_charge_percentage": 90.0000, "estimated_amount": 18165, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 15138.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15138, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 17299.9, "estimated_amount": 17299, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 17299.9, "estimated_amount": 17299, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 17299.9, "estimated_amount": 17299, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 13082, "estimated_amount": 13082, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 18165.8, "standard_charge_percentage": 90.0000, "estimated_amount": 18165, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 17661.2, "standard_charge_percentage": 87.5000, "estimated_amount": 17661, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 16147.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16147, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 16147.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16147, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 16147.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6055.26, "standard_charge_percentage": 30.0000, "estimated_amount": 6055, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 14128.9, "standard_charge_percentage": 70.0000, "estimated_amount": 14128, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 11303.2, "standard_charge_percentage": 56.0000, "estimated_amount": 11303, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 7468.15, "standard_charge_percentage": 37.0000, "estimated_amount": 7468, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16147.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16147, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 12110.5, "standard_charge_percentage": 60.0000, "estimated_amount": 12110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 17299.9, "estimated_amount": 17299, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 17645.9, "estimated_amount": 17645, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 20184.2, "estimated_amount": 20184, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Scapula Fx W Manip", "code_information": [ { "code": "23575", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7886.35, "discounted_cash": 1957,"minimum": 520.65,"maximum": 7886.35,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1964.62, "estimated_amount": 1964, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3943.18, "standard_charge_percentage": 50.0000, "estimated_amount": 3943, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7097.72, "standard_charge_percentage": 90.0000, "estimated_amount": 7097, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6900.56, "standard_charge_percentage": 87.5000, "estimated_amount": 6900, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4731.81, "standard_charge_percentage": 60.0000, "estimated_amount": 4731, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5914.76, "standard_charge_percentage": 75.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5520.44, "standard_charge_percentage": 70.0000, "estimated_amount": 5520, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4416.36, "standard_charge_percentage": 56.0000, "estimated_amount": 4416, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7097.72, "standard_charge_percentage": 90.0000, "estimated_amount": 7097, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5914.76, "standard_charge_percentage": 75.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4731.81, "standard_charge_percentage": 60.0000, "estimated_amount": 4731, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2785.23, "estimated_amount": 2785, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1978.26, "estimated_amount": 1978, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7097.72, "standard_charge_percentage": 90.0000, "estimated_amount": 7097, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6900.56, "standard_charge_percentage": 87.5000, "estimated_amount": 6900, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7886.35, "standard_charge_percentage": 100.0000, "estimated_amount": 7886, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5520.44, "standard_charge_percentage": 70.0000, "estimated_amount": 5520, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2917.95, "standard_charge_percentage": 37.0000, "estimated_amount": 2917, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2032.47, "estimated_amount": 2032, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3011.06, "estimated_amount": 3011, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1438.25, "estimated_amount": 1438, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5914.76, "standard_charge_percentage": 75.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5914.76, "standard_charge_percentage": 75.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7097.72, "standard_charge_percentage": 90.0000, "estimated_amount": 7097, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3154.54, "standard_charge_percentage": 40.0000, "estimated_amount": 3154, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5520.44, "standard_charge_percentage": 70.0000, "estimated_amount": 5520, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5330.88, "estimated_amount": 5330, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1535.64, "estimated_amount": 1535, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 520.65, "estimated_amount": 520, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1950.98, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6703.4, "standard_charge_percentage": 85.0000, "estimated_amount": 6703, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7492.03, "standard_charge_percentage": 95.0000, "estimated_amount": 7492, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7886.35, "standard_charge_percentage": 100.0000, "estimated_amount": 7886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2365.91, "standard_charge_percentage": 30.0000, "estimated_amount": 2365, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5914.76, "standard_charge_percentage": 75.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6466.81, "standard_charge_percentage": 82.0000, "estimated_amount": 6466, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4574.08, "standard_charge_percentage": 58.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7097.72, "standard_charge_percentage": 90.0000, "estimated_amount": 7097, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7728.62, "standard_charge_percentage": 98.0000, "estimated_amount": 7728, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Prox Humerus Fx W Manip", "code_information": [ { "code": "23605", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7772.08, "discounted_cash": 1957,"minimum": 520.65,"maximum": 7772.08,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1964.62, "estimated_amount": 1964, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 520.65, "estimated_amount": 520, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7383.48, "standard_charge_percentage": 95.0000, "estimated_amount": 7383, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7772.08, "standard_charge_percentage": 100.0000, "estimated_amount": 7772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4507.81, "standard_charge_percentage": 58.0000, "estimated_amount": 4507, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5330.88, "estimated_amount": 5330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1978.26, "estimated_amount": 1978, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3796.43, "standard_charge_percentage": 50.0000, "estimated_amount": 3796, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6643.75, "standard_charge_percentage": 87.5000, "estimated_amount": 6643, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7592.86, "standard_charge_percentage": 100.0000, "estimated_amount": 7592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4403.86, "standard_charge_percentage": 58.0000, "estimated_amount": 4403, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7441, "standard_charge_percentage": 98.0000, "estimated_amount": 7441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2785.23, "estimated_amount": 2785, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6800.57, "standard_charge_percentage": 87.5000, "estimated_amount": 6800, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1438.25, "estimated_amount": 1438, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2331.62, "standard_charge_percentage": 30.0000, "estimated_amount": 2331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4663.25, "standard_charge_percentage": 60.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1535.64, "estimated_amount": 1535, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2032.47, "estimated_amount": 2032, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3011.06, "estimated_amount": 3011, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1978.26, "estimated_amount": 1978, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1950.98, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3886.04, "standard_charge_percentage": 50.0000, "estimated_amount": 3886, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6606.27, "standard_charge_percentage": 85.0000, "estimated_amount": 6606, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3108.83, "standard_charge_percentage": 40.0000, "estimated_amount": 3108, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6800.57, "standard_charge_percentage": 87.5000, "estimated_amount": 6800, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7772.08, "standard_charge_percentage": 100.0000, "estimated_amount": 7772, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4663.25, "standard_charge_percentage": 60.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6373.11, "standard_charge_percentage": 82.0000, "estimated_amount": 6373, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4352.36, "standard_charge_percentage": 56.0000, "estimated_amount": 4352, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2875.67, "standard_charge_percentage": 37.0000, "estimated_amount": 2875, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7616.64, "standard_charge_percentage": 98.0000, "estimated_amount": 7616, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2785.23, "estimated_amount": 2785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1964.62, "estimated_amount": 1964, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3037.14, "standard_charge_percentage": 40.0000, "estimated_amount": 3037, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2277.86, "standard_charge_percentage": 30.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2809.36, "standard_charge_percentage": 37.0000, "estimated_amount": 2809, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4555.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4555, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 520.65, "estimated_amount": 520, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1950.98, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6453.93, "standard_charge_percentage": 85.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7213.22, "standard_charge_percentage": 95.0000, "estimated_amount": 7213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4252, "standard_charge_percentage": 56.0000, "estimated_amount": 4252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5330.88, "estimated_amount": 5330, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1535.64, "estimated_amount": 1535, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1438.25, "estimated_amount": 1438, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6643.75, "standard_charge_percentage": 87.5000, "estimated_amount": 6643, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7592.86, "standard_charge_percentage": 100.0000, "estimated_amount": 7592, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4555.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4555, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6226.15, "standard_charge_percentage": 82.0000, "estimated_amount": 6226, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2032.47, "estimated_amount": 2032, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3011.06, "estimated_amount": 3011, "methodology": "fee schedule" }]}]} , { "description": "Optx prox humrl fx w/int fix", "code_information": [ { "code": "23615", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18001, "discounted_cash": 15735,"minimum": 1403,"maximum": 18001,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 13082, "estimated_amount": 13082, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4263.54, "estimated_amount": 4263, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 10968.7, "estimated_amount": 10968, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1403, "estimated_amount": 1403, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 14400.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14400, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 13500.8, "standard_charge_percentage": 75.0000, "estimated_amount": 13500, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 16200.9, "standard_charge_percentage": 90.0000, "estimated_amount": 16200, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 16200.9, "standard_charge_percentage": 90.0000, "estimated_amount": 16200, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 16200.9, "standard_charge_percentage": 90.0000, "estimated_amount": 16200, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 15300.9, "standard_charge_percentage": 85.0000, "estimated_amount": 15300, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 14400.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 14400.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 18001, "standard_charge_percentage": 100.0000, "estimated_amount": 18001, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 13500.8, "standard_charge_percentage": 75.0000, "estimated_amount": 13500, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 10440.6, "standard_charge_percentage": 58.0000, "estimated_amount": 10440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 16945.7, "estimated_amount": 16945, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 12709.3, "estimated_amount": 12709, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 18001, "estimated_amount": 18001, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 15904.6, "estimated_amount": 15904, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 13500.8, "standard_charge_percentage": 75.0000, "estimated_amount": 13500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14400.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 15750.9, "standard_charge_percentage": 87.5000, "estimated_amount": 15750, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 14400.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14400, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 14400.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14400, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 12600.7, "standard_charge_percentage": 70.0000, "estimated_amount": 12600, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10080.6, "standard_charge_percentage": 56.0000, "estimated_amount": 10080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14400.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14400, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 16200.9, "standard_charge_percentage": 90.0000, "estimated_amount": 16200, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 17641, "standard_charge_percentage": 98.0000, "estimated_amount": 17640, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 13500.8, "standard_charge_percentage": 75.0000, "estimated_amount": 13500, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 18001, "estimated_amount": 18001, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 12709.3, "estimated_amount": 12709, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 12346.2, "estimated_amount": 12346, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 18001, "estimated_amount": 18001, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 16945.7, "estimated_amount": 16945, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 15795, "estimated_amount": 15794, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 15685.3, "estimated_amount": 15685, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9000.5, "standard_charge_percentage": 50.0000, "estimated_amount": 9000, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 15750.9, "standard_charge_percentage": 87.5000, "estimated_amount": 15750, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 18001, "standard_charge_percentage": 100.0000, "estimated_amount": 18001, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 17101, "standard_charge_percentage": 95.0000, "estimated_amount": 17100, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 10800.6, "standard_charge_percentage": 60.0000, "estimated_amount": 10800, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 14400.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14400, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 12600.7, "standard_charge_percentage": 70.0000, "estimated_amount": 12600, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 13500.8, "standard_charge_percentage": 75.0000, "estimated_amount": 13500, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 10800.6, "standard_charge_percentage": 60.0000, "estimated_amount": 10800, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 16340.5, "estimated_amount": 16340, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 18001, "estimated_amount": 18001, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 10968.7, "estimated_amount": 10968, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7200.4, "standard_charge_percentage": 40.0000, "estimated_amount": 7200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14400.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14400, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 14400.8, "standard_charge_percentage": 80.0000, "estimated_amount": 14400, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5400.3, "standard_charge_percentage": 30.0000, "estimated_amount": 5400, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 12600.7, "standard_charge_percentage": 70.0000, "estimated_amount": 12600, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 14760.8, "standard_charge_percentage": 82.0000, "estimated_amount": 14760, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 16200.9, "standard_charge_percentage": 90.0000, "estimated_amount": 16200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 18001, "estimated_amount": 18001, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Shldr Disloc W Manip Wo Anes", "code_information": [ { "code": "23650", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 260, "estimated_amount": 260, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Shldr Disloc,Gr Tub Fx, W Manip", "code_information": [ { "code": "23665", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7886.35, "discounted_cash": 1957,"minimum": 520.65,"maximum": 7886.35,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 520.65, "estimated_amount": 520, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6900.56, "standard_charge_percentage": 87.5000, "estimated_amount": 6900, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4731.81, "standard_charge_percentage": 60.0000, "estimated_amount": 4731, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2365.91, "standard_charge_percentage": 30.0000, "estimated_amount": 2365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5914.76, "standard_charge_percentage": 75.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7097.72, "standard_charge_percentage": 90.0000, "estimated_amount": 7097, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7728.62, "standard_charge_percentage": 98.0000, "estimated_amount": 7728, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2785.23, "estimated_amount": 2785, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5914.76, "standard_charge_percentage": 75.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5914.76, "standard_charge_percentage": 75.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7097.72, "standard_charge_percentage": 90.0000, "estimated_amount": 7097, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3154.54, "standard_charge_percentage": 40.0000, "estimated_amount": 3154, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2917.95, "standard_charge_percentage": 37.0000, "estimated_amount": 2917, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5330.88, "estimated_amount": 5330, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1535.64, "estimated_amount": 1535, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3011.06, "estimated_amount": 3011, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1964.62, "estimated_amount": 1964, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1438.25, "estimated_amount": 1438, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7097.72, "standard_charge_percentage": 90.0000, "estimated_amount": 7097, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7886.35, "standard_charge_percentage": 100.0000, "estimated_amount": 7886, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5520.44, "standard_charge_percentage": 70.0000, "estimated_amount": 5520, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5520.44, "standard_charge_percentage": 70.0000, "estimated_amount": 5520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4731.81, "standard_charge_percentage": 60.0000, "estimated_amount": 4731, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1978.26, "estimated_amount": 1978, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1950.98, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3943.18, "standard_charge_percentage": 50.0000, "estimated_amount": 3943, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7097.72, "standard_charge_percentage": 90.0000, "estimated_amount": 7097, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6703.4, "standard_charge_percentage": 85.0000, "estimated_amount": 6703, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6900.56, "standard_charge_percentage": 87.5000, "estimated_amount": 6900, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7492.03, "standard_charge_percentage": 95.0000, "estimated_amount": 7492, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7886.35, "standard_charge_percentage": 100.0000, "estimated_amount": 7886, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6309.08, "standard_charge_percentage": 80.0000, "estimated_amount": 6309, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5520.44, "standard_charge_percentage": 70.0000, "estimated_amount": 5520, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5914.76, "standard_charge_percentage": 75.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6466.81, "standard_charge_percentage": 82.0000, "estimated_amount": 6466, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4416.36, "standard_charge_percentage": 56.0000, "estimated_amount": 4416, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4574.08, "standard_charge_percentage": 58.0000, "estimated_amount": 4574, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7097.72, "standard_charge_percentage": 90.0000, "estimated_amount": 7097, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5914.76, "standard_charge_percentage": 75.0000, "estimated_amount": 5914, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2032.47, "estimated_amount": 2032, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" }]}]} , { "description": "Excision Olecranon Bursa", "code_information": [ { "code": "24105", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7592.86, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 7592.86,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3037.14, "standard_charge_percentage": 40.0000, "estimated_amount": 3037, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4403.86, "standard_charge_percentage": 58.0000, "estimated_amount": 4403, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7441, "standard_charge_percentage": 98.0000, "estimated_amount": 7441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4555.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4555, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 7592.86, "estimated_amount": 7592, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6643.75, "standard_charge_percentage": 87.5000, "estimated_amount": 6643, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2277.86, "standard_charge_percentage": 30.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4252, "standard_charge_percentage": 56.0000, "estimated_amount": 4252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3796.43, "standard_charge_percentage": 50.0000, "estimated_amount": 3796, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6643.75, "standard_charge_percentage": 87.5000, "estimated_amount": 6643, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4555.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4555, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6453.93, "standard_charge_percentage": 85.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7592.86, "standard_charge_percentage": 100.0000, "estimated_amount": 7592, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7213.22, "standard_charge_percentage": 95.0000, "estimated_amount": 7213, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7592.86, "standard_charge_percentage": 100.0000, "estimated_amount": 7592, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6226.15, "standard_charge_percentage": 82.0000, "estimated_amount": 6226, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" }]}]} , { "description": "Hc Injection For Elbow Arthrogram", "code_information": [ { "code": "24220", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1425.56,"minimum": 74.43,"maximum": 1425.56,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1425.56, "estimated_amount": 1425, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1069.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1069.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 712.78, "standard_charge_percentage": 50.0000, "estimated_amount": 712, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1283, "standard_charge_percentage": 90.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1283, "standard_charge_percentage": 90.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1247.37, "standard_charge_percentage": 87.5000, "estimated_amount": 1247, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 997.89, "standard_charge_percentage": 70.0000, "estimated_amount": 997, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 798.31, "standard_charge_percentage": 56.0000, "estimated_amount": 798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1140.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1283, "standard_charge_percentage": 90.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1069.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 855.34, "standard_charge_percentage": 60.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1211.73, "standard_charge_percentage": 85.0000, "estimated_amount": 1211, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1247.37, "standard_charge_percentage": 87.5000, "estimated_amount": 1247, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1425.56, "standard_charge_percentage": 100.0000, "estimated_amount": 1425, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1425.56, "standard_charge_percentage": 100.0000, "estimated_amount": 1425, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 855.34, "standard_charge_percentage": 60.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 427.67, "standard_charge_percentage": 30.0000, "estimated_amount": 427, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 826.82, "standard_charge_percentage": 58.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 74.43, "estimated_amount": 74, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1283, "standard_charge_percentage": 90.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1140.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1354.28, "standard_charge_percentage": 95.0000, "estimated_amount": 1354, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1140.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1140.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1140.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1140.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1069.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 997.89, "standard_charge_percentage": 70.0000, "estimated_amount": 997, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1069.17, "standard_charge_percentage": 75.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1168.96, "standard_charge_percentage": 82.0000, "estimated_amount": 1168, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 527.46, "standard_charge_percentage": 37.0000, "estimated_amount": 527, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1140.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1140.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 570.22, "standard_charge_percentage": 40.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1140.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1140.45, "standard_charge_percentage": 80.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 997.89, "standard_charge_percentage": 70.0000, "estimated_amount": 997, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1283, "standard_charge_percentage": 90.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1397.05, "standard_charge_percentage": 98.0000, "estimated_amount": 1397, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "24342", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9295.6, "discounted_cash": 8736,"minimum": 1123,"maximum": 9295.6,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6971.7, "standard_charge_percentage": 75.0000, "estimated_amount": 6971, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7436.48, "standard_charge_percentage": 80.0000, "estimated_amount": 7436, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7901.26, "standard_charge_percentage": 85.0000, "estimated_amount": 7901, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3718.24, "standard_charge_percentage": 40.0000, "estimated_amount": 3718, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8133.65, "standard_charge_percentage": 87.5000, "estimated_amount": 8133, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9295.6, "standard_charge_percentage": 100.0000, "estimated_amount": 9295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7436.48, "standard_charge_percentage": 80.0000, "estimated_amount": 7436, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7436.48, "standard_charge_percentage": 80.0000, "estimated_amount": 7436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2788.68, "standard_charge_percentage": 30.0000, "estimated_amount": 2788, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5205.54, "standard_charge_percentage": 56.0000, "estimated_amount": 5205, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8366.04, "standard_charge_percentage": 90.0000, "estimated_amount": 8366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9295.6, "standard_charge_percentage": 100.0000, "estimated_amount": 9295, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7436.48, "standard_charge_percentage": 80.0000, "estimated_amount": 7436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6971.7, "standard_charge_percentage": 75.0000, "estimated_amount": 6971, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6506.92, "standard_charge_percentage": 70.0000, "estimated_amount": 6506, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6506.92, "standard_charge_percentage": 70.0000, "estimated_amount": 6506, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6971.7, "standard_charge_percentage": 75.0000, "estimated_amount": 6971, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9109.69, "standard_charge_percentage": 98.0000, "estimated_amount": 9109, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6971.7, "standard_charge_percentage": 75.0000, "estimated_amount": 6971, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5577.36, "standard_charge_percentage": 60.0000, "estimated_amount": 5577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 9295.6, "estimated_amount": 9295, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9295.6, "estimated_amount": 9295, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6971.7, "standard_charge_percentage": 75.0000, "estimated_amount": 6971, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8366.04, "standard_charge_percentage": 90.0000, "estimated_amount": 8366, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8366.04, "standard_charge_percentage": 90.0000, "estimated_amount": 8366, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8133.65, "standard_charge_percentage": 87.5000, "estimated_amount": 8133, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7436.48, "standard_charge_percentage": 80.0000, "estimated_amount": 7436, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7436.48, "standard_charge_percentage": 80.0000, "estimated_amount": 7436, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8830.82, "standard_charge_percentage": 95.0000, "estimated_amount": 8830, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5577.36, "standard_charge_percentage": 60.0000, "estimated_amount": 5577, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7436.48, "standard_charge_percentage": 80.0000, "estimated_amount": 7436, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8366.04, "standard_charge_percentage": 90.0000, "estimated_amount": 8366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9295.6, "estimated_amount": 9295, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9295.6, "estimated_amount": 9295, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 9295.6, "estimated_amount": 9295, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 9295.6, "estimated_amount": 9295, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7436.48, "standard_charge_percentage": 80.0000, "estimated_amount": 7436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4647.8, "standard_charge_percentage": 50.0000, "estimated_amount": 4647, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8366.04, "standard_charge_percentage": 90.0000, "estimated_amount": 8366, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7436.48, "standard_charge_percentage": 80.0000, "estimated_amount": 7436, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6506.92, "standard_charge_percentage": 70.0000, "estimated_amount": 6506, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7622.39, "standard_charge_percentage": 82.0000, "estimated_amount": 7622, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5391.45, "standard_charge_percentage": 58.0000, "estimated_amount": 5391, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7436.48, "standard_charge_percentage": 80.0000, "estimated_amount": 7436, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9295.6, "estimated_amount": 9295, "methodology": "fee schedule" }]}]} , { "description": "Repair elbow deb/attch open", "code_information": [ { "code": "24359", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 11900.9, "discounted_cash": 3967,"minimum": 1256.84,"maximum": 11900.9,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 8925.67, "standard_charge_percentage": 75.0000, "estimated_amount": 8925, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 8925.67, "standard_charge_percentage": 75.0000, "estimated_amount": 8925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 9520.72, "standard_charge_percentage": 80.0000, "estimated_amount": 9520, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 10710.8, "standard_charge_percentage": 90.0000, "estimated_amount": 10710, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 10115.8, "standard_charge_percentage": 85.0000, "estimated_amount": 10115, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 10413.3, "standard_charge_percentage": 87.5000, "estimated_amount": 10413, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 9520.72, "standard_charge_percentage": 80.0000, "estimated_amount": 9520, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 11900.9, "standard_charge_percentage": 100.0000, "estimated_amount": 11900, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 11305.9, "standard_charge_percentage": 95.0000, "estimated_amount": 11305, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 11900.9, "standard_charge_percentage": 100.0000, "estimated_amount": 11900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 9520.72, "standard_charge_percentage": 80.0000, "estimated_amount": 9520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3570.27, "standard_charge_percentage": 30.0000, "estimated_amount": 3570, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 8330.63, "standard_charge_percentage": 70.0000, "estimated_amount": 8330, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 8925.67, "standard_charge_percentage": 75.0000, "estimated_amount": 8925, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 9758.74, "standard_charge_percentage": 82.0000, "estimated_amount": 9758, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 6664.5, "standard_charge_percentage": 56.0000, "estimated_amount": 6664, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 9520.72, "standard_charge_percentage": 80.0000, "estimated_amount": 9520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 10807.7, "estimated_amount": 10807, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 10710.8, "standard_charge_percentage": 90.0000, "estimated_amount": 10710, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 9520.72, "standard_charge_percentage": 80.0000, "estimated_amount": 9520, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 8330.63, "standard_charge_percentage": 70.0000, "estimated_amount": 8330, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 4403.33, "standard_charge_percentage": 37.0000, "estimated_amount": 4403, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 10710.8, "standard_charge_percentage": 90.0000, "estimated_amount": 10710, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1256.84, "estimated_amount": 1256, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 5950.45, "standard_charge_percentage": 50.0000, "estimated_amount": 5950, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 10710.8, "standard_charge_percentage": 90.0000, "estimated_amount": 10710, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 10413.3, "standard_charge_percentage": 87.5000, "estimated_amount": 10413, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 7140.54, "standard_charge_percentage": 60.0000, "estimated_amount": 7140, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 9520.72, "standard_charge_percentage": 80.0000, "estimated_amount": 9520, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 9520.72, "standard_charge_percentage": 80.0000, "estimated_amount": 9520, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 9520.72, "standard_charge_percentage": 80.0000, "estimated_amount": 9520, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 8330.63, "standard_charge_percentage": 70.0000, "estimated_amount": 8330, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 6902.52, "standard_charge_percentage": 58.0000, "estimated_amount": 6902, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 10710.8, "standard_charge_percentage": 90.0000, "estimated_amount": 10710, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 11662.9, "standard_charge_percentage": 98.0000, "estimated_amount": 11662, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 9520.72, "standard_charge_percentage": 80.0000, "estimated_amount": 9520, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 4760.36, "standard_charge_percentage": 40.0000, "estimated_amount": 4760, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 9520.72, "standard_charge_percentage": 80.0000, "estimated_amount": 9520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 8925.67, "standard_charge_percentage": 75.0000, "estimated_amount": 8925, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 8925.67, "standard_charge_percentage": 75.0000, "estimated_amount": 8925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 7140.54, "standard_charge_percentage": 60.0000, "estimated_amount": 7140, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Elbow Disloc Wo Anes", "code_information": [ { "code": "24600", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" }]}]} , { "description": "Treat Elbow Dislocation", "code_information": [ { "code": "24605", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7596.04, "discounted_cash": 1957,"minimum": 520.65,"maximum": 7596.04,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 520.65, "estimated_amount": 520, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1950.98, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6076.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6076, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6456.63, "standard_charge_percentage": 85.0000, "estimated_amount": 6456, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3038.42, "standard_charge_percentage": 40.0000, "estimated_amount": 3038, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6646.53, "standard_charge_percentage": 87.5000, "estimated_amount": 6646, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6076.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6076, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6076.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2278.81, "standard_charge_percentage": 30.0000, "estimated_amount": 2278, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5317.23, "standard_charge_percentage": 70.0000, "estimated_amount": 5317, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4253.78, "standard_charge_percentage": 56.0000, "estimated_amount": 4253, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4405.7, "standard_charge_percentage": 58.0000, "estimated_amount": 4405, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6836.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6836, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5697.03, "standard_charge_percentage": 75.0000, "estimated_amount": 5697, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5330.88, "estimated_amount": 5330, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1535.64, "estimated_amount": 1535, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3011.06, "estimated_amount": 3011, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1978.26, "estimated_amount": 1978, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3798.02, "standard_charge_percentage": 50.0000, "estimated_amount": 3798, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6836.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6836, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6076.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6076.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6076, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6076.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6076, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6228.75, "standard_charge_percentage": 82.0000, "estimated_amount": 6228, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2785.23, "estimated_amount": 2785, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1964.62, "estimated_amount": 1964, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1438.25, "estimated_amount": 1438, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5697.03, "standard_charge_percentage": 75.0000, "estimated_amount": 5697, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5697.03, "standard_charge_percentage": 75.0000, "estimated_amount": 5697, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6646.53, "standard_charge_percentage": 87.5000, "estimated_amount": 6646, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6076.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6076, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5697.03, "standard_charge_percentage": 75.0000, "estimated_amount": 5697, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6076.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6076, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6836.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6076.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6076, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6836.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6836, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6836.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6836, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6076.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6076, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7596.04, "standard_charge_percentage": 100.0000, "estimated_amount": 7596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7216.24, "standard_charge_percentage": 95.0000, "estimated_amount": 7216, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7596.04, "standard_charge_percentage": 100.0000, "estimated_amount": 7596, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4557.62, "standard_charge_percentage": 60.0000, "estimated_amount": 4557, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5697.03, "standard_charge_percentage": 75.0000, "estimated_amount": 5697, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5317.23, "standard_charge_percentage": 70.0000, "estimated_amount": 5317, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5317.23, "standard_charge_percentage": 70.0000, "estimated_amount": 5317, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7444.12, "standard_charge_percentage": 98.0000, "estimated_amount": 7444, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4557.62, "standard_charge_percentage": 60.0000, "estimated_amount": 4557, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2032.47, "estimated_amount": 2032, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Radial Head Disloc Child W Amnip", "code_information": [ { "code": "24640", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 364, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" }]}]} , { "description": "Treat Ulnar Fracture", "code_information": [ { "code": "24685", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 12688.7, "discounted_cash": 8736,"minimum": 1123,"maximum": 12688.7,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 11419.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11419, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 11102.6, "standard_charge_percentage": 87.5000, "estimated_amount": 11102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 12054.3, "standard_charge_percentage": 95.0000, "estimated_amount": 12054, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3806.61, "standard_charge_percentage": 30.0000, "estimated_amount": 3806, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 12434.9, "standard_charge_percentage": 98.0000, "estimated_amount": 12434, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 9516.52, "standard_charge_percentage": 75.0000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 11419.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11419, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 10785.4, "standard_charge_percentage": 85.0000, "estimated_amount": 10785, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 11102.6, "standard_charge_percentage": 87.5000, "estimated_amount": 11102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 12688.7, "standard_charge_percentage": 100.0000, "estimated_amount": 12688, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 12688.7, "standard_charge_percentage": 100.0000, "estimated_amount": 12688, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 9516.52, "standard_charge_percentage": 75.0000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 8882.09, "standard_charge_percentage": 70.0000, "estimated_amount": 8882, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 8882.09, "standard_charge_percentage": 70.0000, "estimated_amount": 8882, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 7105.67, "standard_charge_percentage": 56.0000, "estimated_amount": 7105, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 7359.45, "standard_charge_percentage": 58.0000, "estimated_amount": 7359, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 9516.52, "standard_charge_percentage": 75.0000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6344.35, "standard_charge_percentage": 50.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 11419.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11419, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 9516.52, "standard_charge_percentage": 75.0000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 10404.7, "standard_charge_percentage": 82.0000, "estimated_amount": 10404, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5075.48, "standard_charge_percentage": 40.0000, "estimated_amount": 5075, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 7613.22, "standard_charge_percentage": 60.0000, "estimated_amount": 7613, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 10151, "standard_charge_percentage": 80.0000, "estimated_amount": 10150, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 8882.09, "standard_charge_percentage": 70.0000, "estimated_amount": 8882, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 11419.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11419, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 11419.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11419, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 9516.52, "standard_charge_percentage": 75.0000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 7613.22, "standard_charge_percentage": 60.0000, "estimated_amount": 7613, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 12688.7, "estimated_amount": 12688, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 12688.7, "estimated_amount": 12688, "methodology": "fee schedule" }]}]} , { "description": "Hc Upper Arm/Elbow Surgery Unlisted", "code_information": [ { "code": "24999", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 125.74,"maximum": 1150.1,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 125.74, "estimated_amount": 125, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" }]}]} , { "description": "Hc Biopsy Forearm Soft Tissues,Superfic", "code_information": [ { "code": "25065", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7851.2, "discounted_cash": 1981,"minimum": 525.22,"maximum": 7851.2,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7851.2, "standard_charge_percentage": 100.0000, "estimated_amount": 7851, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7851.2, "standard_charge_percentage": 100.0000, "estimated_amount": 7851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2355.36, "standard_charge_percentage": 30.0000, "estimated_amount": 2355, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5495.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5495, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5495.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5495, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4710.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4710, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6673.52, "standard_charge_percentage": 85.0000, "estimated_amount": 6673, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6869.8, "standard_charge_percentage": 87.5000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5495.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5495, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6437.98, "standard_charge_percentage": 82.0000, "estimated_amount": 6437, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2904.94, "standard_charge_percentage": 37.0000, "estimated_amount": 2904, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7694.18, "standard_charge_percentage": 98.0000, "estimated_amount": 7694, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3140.48, "standard_charge_percentage": 40.0000, "estimated_amount": 3140, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6869.8, "standard_charge_percentage": 87.5000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7458.64, "standard_charge_percentage": 95.0000, "estimated_amount": 7458, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4710.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4710, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4553.7, "standard_charge_percentage": 58.0000, "estimated_amount": 4553, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3925.6, "standard_charge_percentage": 50.0000, "estimated_amount": 3925, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4396.67, "standard_charge_percentage": 56.0000, "estimated_amount": 4396, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "Hc Inj For Wrist X-Ray", "code_information": [ { "code": "25246", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1302.26,"minimum": 260,"maximum": 1302.26,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 520.9, "standard_charge_percentage": 40.0000, "estimated_amount": 520, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1139.48, "standard_charge_percentage": 87.5000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1237.15, "standard_charge_percentage": 95.0000, "estimated_amount": 1237, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 390.68, "standard_charge_percentage": 30.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1276.21, "standard_charge_percentage": 98.0000, "estimated_amount": 1276, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1139.48, "standard_charge_percentage": 87.5000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1302.26, "standard_charge_percentage": 100.0000, "estimated_amount": 1302, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 781.36, "standard_charge_percentage": 60.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 729.27, "standard_charge_percentage": 56.0000, "estimated_amount": 729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 260, "estimated_amount": 260, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1302.26, "estimated_amount": 1302, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1067.85, "standard_charge_percentage": 82.0000, "estimated_amount": 1067, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 481.84, "standard_charge_percentage": 37.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 781.36, "standard_charge_percentage": 60.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 651.13, "standard_charge_percentage": 50.0000, "estimated_amount": 651, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1106.92, "standard_charge_percentage": 85.0000, "estimated_amount": 1106, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1302.26, "standard_charge_percentage": 100.0000, "estimated_amount": 1302, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 755.31, "standard_charge_percentage": 58.0000, "estimated_amount": 755, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "25447", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9063.07, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 9063.07,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4531.53, "standard_charge_percentage": 50.0000, "estimated_amount": 4531, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7703.61, "standard_charge_percentage": 85.0000, "estimated_amount": 7703, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3625.23, "standard_charge_percentage": 40.0000, "estimated_amount": 3625, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7930.19, "standard_charge_percentage": 87.5000, "estimated_amount": 7930, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6344.15, "standard_charge_percentage": 70.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5256.58, "standard_charge_percentage": 58.0000, "estimated_amount": 5256, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7930.19, "standard_charge_percentage": 87.5000, "estimated_amount": 7930, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2718.92, "standard_charge_percentage": 30.0000, "estimated_amount": 2718, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6344.15, "standard_charge_percentage": 70.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5437.84, "standard_charge_percentage": 60.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4489, "estimated_amount": 4489, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9063.07, "standard_charge_percentage": 100.0000, "estimated_amount": 9063, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5437.84, "standard_charge_percentage": 60.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5075.32, "standard_charge_percentage": 56.0000, "estimated_amount": 5075, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1627, "estimated_amount": 1627, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9063.07, "standard_charge_percentage": 100.0000, "estimated_amount": 9063, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8609.92, "standard_charge_percentage": 95.0000, "estimated_amount": 8609, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6344.15, "standard_charge_percentage": 70.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7431.72, "standard_charge_percentage": 82.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8881.81, "standard_charge_percentage": 98.0000, "estimated_amount": 8881, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9063.07, "estimated_amount": 9063, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Rad/Ulna Shaft Fx W Manip", "code_information": [ { "code": "25565", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7609.41, "discounted_cash": 1957,"minimum": 520.65,"maximum": 7609.41,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1978.26, "estimated_amount": 1978, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6848.47, "standard_charge_percentage": 90.0000, "estimated_amount": 6848, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6848.47, "standard_charge_percentage": 90.0000, "estimated_amount": 6848, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7228.94, "standard_charge_percentage": 95.0000, "estimated_amount": 7228, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7609.41, "standard_charge_percentage": 100.0000, "estimated_amount": 7609, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4565.65, "standard_charge_percentage": 60.0000, "estimated_amount": 4565, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6087.53, "standard_charge_percentage": 80.0000, "estimated_amount": 6087, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5326.59, "standard_charge_percentage": 70.0000, "estimated_amount": 5326, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4261.27, "standard_charge_percentage": 56.0000, "estimated_amount": 4261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6087.53, "standard_charge_percentage": 80.0000, "estimated_amount": 6087, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7457.22, "standard_charge_percentage": 98.0000, "estimated_amount": 7457, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5707.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5707, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5330.88, "estimated_amount": 5330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1964.62, "estimated_amount": 1964, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 520.65, "estimated_amount": 520, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1950.98, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6087.53, "standard_charge_percentage": 80.0000, "estimated_amount": 6087, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5707.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5707, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6087.53, "standard_charge_percentage": 80.0000, "estimated_amount": 6087, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3804.7, "standard_charge_percentage": 50.0000, "estimated_amount": 3804, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6848.47, "standard_charge_percentage": 90.0000, "estimated_amount": 6848, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6468, "standard_charge_percentage": 85.0000, "estimated_amount": 6468, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6658.23, "standard_charge_percentage": 87.5000, "estimated_amount": 6658, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6087.53, "standard_charge_percentage": 80.0000, "estimated_amount": 6087, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6087.53, "standard_charge_percentage": 80.0000, "estimated_amount": 6087, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6087.53, "standard_charge_percentage": 80.0000, "estimated_amount": 6087, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6087.53, "standard_charge_percentage": 80.0000, "estimated_amount": 6087, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5707.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5707, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5326.59, "standard_charge_percentage": 70.0000, "estimated_amount": 5326, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4413.46, "standard_charge_percentage": 58.0000, "estimated_amount": 4413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3011.06, "estimated_amount": 3011, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1438.25, "estimated_amount": 1438, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5707.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5707, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6087.53, "standard_charge_percentage": 80.0000, "estimated_amount": 6087, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7609.41, "standard_charge_percentage": 100.0000, "estimated_amount": 7609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6087.53, "standard_charge_percentage": 80.0000, "estimated_amount": 6087, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2282.82, "standard_charge_percentage": 30.0000, "estimated_amount": 2282, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5326.59, "standard_charge_percentage": 70.0000, "estimated_amount": 5326, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5707.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5707, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6848.47, "standard_charge_percentage": 90.0000, "estimated_amount": 6848, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4565.65, "standard_charge_percentage": 60.0000, "estimated_amount": 4565, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2032.47, "estimated_amount": 2032, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2785.23, "estimated_amount": 2785, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3043.76, "standard_charge_percentage": 40.0000, "estimated_amount": 3043, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6658.23, "standard_charge_percentage": 87.5000, "estimated_amount": 6658, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6239.72, "standard_charge_percentage": 82.0000, "estimated_amount": 6239, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2815.48, "standard_charge_percentage": 37.0000, "estimated_amount": 2815, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6848.47, "standard_charge_percentage": 90.0000, "estimated_amount": 6848, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1535.64, "estimated_amount": 1535, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "25575", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 16919, "discounted_cash": 8736,"minimum": 1123,"maximum": 16919,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 12689.3, "standard_charge_percentage": 75.0000, "estimated_amount": 12689, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 14804.2, "standard_charge_percentage": 87.5000, "estimated_amount": 14804, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 14804.2, "standard_charge_percentage": 87.5000, "estimated_amount": 14804, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 13535.2, "standard_charge_percentage": 80.0000, "estimated_amount": 13535, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 13535.2, "standard_charge_percentage": 80.0000, "estimated_amount": 13535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5075.71, "standard_charge_percentage": 30.0000, "estimated_amount": 5075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 13535.2, "standard_charge_percentage": 80.0000, "estimated_amount": 13535, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 12689.3, "standard_charge_percentage": 75.0000, "estimated_amount": 12689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13440.5, "estimated_amount": 13440, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 12689.3, "standard_charge_percentage": 75.0000, "estimated_amount": 12689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 8459.52, "standard_charge_percentage": 50.0000, "estimated_amount": 8459, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 15227.1, "standard_charge_percentage": 90.0000, "estimated_amount": 15227, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6767.62, "standard_charge_percentage": 40.0000, "estimated_amount": 6767, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 16073.1, "standard_charge_percentage": 95.0000, "estimated_amount": 16073, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 16919, "standard_charge_percentage": 100.0000, "estimated_amount": 16919, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 10151.4, "standard_charge_percentage": 60.0000, "estimated_amount": 10151, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 11843.3, "standard_charge_percentage": 70.0000, "estimated_amount": 11843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 9474.66, "standard_charge_percentage": 56.0000, "estimated_amount": 9474, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 15227.1, "standard_charge_percentage": 90.0000, "estimated_amount": 15227, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 15227.1, "standard_charge_percentage": 90.0000, "estimated_amount": 15227, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 16580.7, "standard_charge_percentage": 98.0000, "estimated_amount": 16580, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 14381.2, "standard_charge_percentage": 85.0000, "estimated_amount": 14381, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 16919, "standard_charge_percentage": 100.0000, "estimated_amount": 16919, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 11843.3, "standard_charge_percentage": 70.0000, "estimated_amount": 11843, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 12689.3, "standard_charge_percentage": 75.0000, "estimated_amount": 12689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 10151.4, "standard_charge_percentage": 60.0000, "estimated_amount": 10151, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 16919, "estimated_amount": 16919, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 13535.2, "standard_charge_percentage": 80.0000, "estimated_amount": 13535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 13535.2, "standard_charge_percentage": 80.0000, "estimated_amount": 13535, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 15227.1, "standard_charge_percentage": 90.0000, "estimated_amount": 15227, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 15227.1, "standard_charge_percentage": 90.0000, "estimated_amount": 15227, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 13535.2, "standard_charge_percentage": 80.0000, "estimated_amount": 13535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 13535.2, "standard_charge_percentage": 80.0000, "estimated_amount": 13535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 13535.2, "standard_charge_percentage": 80.0000, "estimated_amount": 13535, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 13535.2, "standard_charge_percentage": 80.0000, "estimated_amount": 13535, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 13535.2, "standard_charge_percentage": 80.0000, "estimated_amount": 13535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 12689.3, "standard_charge_percentage": 75.0000, "estimated_amount": 12689, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 11843.3, "standard_charge_percentage": 70.0000, "estimated_amount": 11843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 13873.6, "standard_charge_percentage": 82.0000, "estimated_amount": 13873, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9813.04, "standard_charge_percentage": 58.0000, "estimated_amount": 9813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Distl Rad/Ulna Fx Wo Manip", "code_information": [ { "code": "25600", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Distl Rad/Ulna Fx W Manip", "code_information": [ { "code": "25605", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7772.08, "discounted_cash": 1957,"minimum": 520.65,"maximum": 7772.08,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1950.98, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3108.83, "standard_charge_percentage": 40.0000, "estimated_amount": 3108, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7772.08, "standard_charge_percentage": 100.0000, "estimated_amount": 7772, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7772.08, "standard_charge_percentage": 100.0000, "estimated_amount": 7772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2331.62, "standard_charge_percentage": 30.0000, "estimated_amount": 2331, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6373.11, "standard_charge_percentage": 82.0000, "estimated_amount": 6373, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4663.25, "standard_charge_percentage": 60.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5330.88, "estimated_amount": 5330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3886.04, "standard_charge_percentage": 50.0000, "estimated_amount": 3886, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6800.57, "standard_charge_percentage": 87.5000, "estimated_amount": 6800, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4352.36, "standard_charge_percentage": 56.0000, "estimated_amount": 4352, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2032.47, "estimated_amount": 2032, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3011.06, "estimated_amount": 3011, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1964.62, "estimated_amount": 1964, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1438.25, "estimated_amount": 1438, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 520.65, "estimated_amount": 520, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6606.27, "standard_charge_percentage": 85.0000, "estimated_amount": 6606, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7383.48, "standard_charge_percentage": 95.0000, "estimated_amount": 7383, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4507.81, "standard_charge_percentage": 58.0000, "estimated_amount": 4507, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1535.64, "estimated_amount": 1535, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1978.26, "estimated_amount": 1978, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6800.57, "standard_charge_percentage": 87.5000, "estimated_amount": 6800, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4663.25, "standard_charge_percentage": 60.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2875.67, "standard_charge_percentage": 37.0000, "estimated_amount": 2875, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7616.64, "standard_charge_percentage": 98.0000, "estimated_amount": 7616, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2785.23, "estimated_amount": 2785, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "25607", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 15710.5, "discounted_cash": 8736,"minimum": 1627,"maximum": 15710.5,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 7855.24, "standard_charge_percentage": 50.0000, "estimated_amount": 7855, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 13353.9, "standard_charge_percentage": 85.0000, "estimated_amount": 13353, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 13746.7, "standard_charge_percentage": 87.5000, "estimated_amount": 13746, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 12568.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12568, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 12568.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12568, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 12568.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12568, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 15710.5, "standard_charge_percentage": 100.0000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 14925, "standard_charge_percentage": 95.0000, "estimated_amount": 14924, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 9426.29, "standard_charge_percentage": 60.0000, "estimated_amount": 9426, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 12568.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12568, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 30.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 11782.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11782, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 12882.6, "standard_charge_percentage": 82.0000, "estimated_amount": 12882, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 15396.3, "standard_charge_percentage": 98.0000, "estimated_amount": 15396, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 9426.29, "standard_charge_percentage": 60.0000, "estimated_amount": 9426, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13440.5, "estimated_amount": 13440, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 14139.4, "standard_charge_percentage": 90.0000, "estimated_amount": 14139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12568.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12568, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8797.87, "standard_charge_percentage": 56.0000, "estimated_amount": 8797, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9112.08, "standard_charge_percentage": 58.0000, "estimated_amount": 9112, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 15710.5, "estimated_amount": 15710, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2377.51, "estimated_amount": 2377, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4489, "estimated_amount": 4489, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 12568.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12568, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 14139.4, "standard_charge_percentage": 90.0000, "estimated_amount": 14139, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6284.19, "standard_charge_percentage": 40.0000, "estimated_amount": 6284, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 15710.5, "standard_charge_percentage": 100.0000, "estimated_amount": 15710, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 12568.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12568, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 12568.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12568, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 10997.3, "standard_charge_percentage": 70.0000, "estimated_amount": 10997, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 10997.3, "standard_charge_percentage": 70.0000, "estimated_amount": 10997, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12568.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12568, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 14139.4, "standard_charge_percentage": 90.0000, "estimated_amount": 14139, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 14139.4, "standard_charge_percentage": 90.0000, "estimated_amount": 14139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1627, "estimated_amount": 1627, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 11782.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11782, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 11782.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12568.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12568, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 14139.4, "standard_charge_percentage": 90.0000, "estimated_amount": 14139, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 13746.7, "standard_charge_percentage": 87.5000, "estimated_amount": 13746, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 11782.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11782, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 10997.3, "standard_charge_percentage": 70.0000, "estimated_amount": 10997, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 11782.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11782, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" }]}]} , { "description": "Optx dst rd xart fx/ep sep3+", "code_information": [ { "code": "25609", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9408.82, "discounted_cash": 8736,"minimum": 1627,"maximum": 9408.82,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2377.51, "estimated_amount": 2377, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7056.61, "standard_charge_percentage": 75.0000, "estimated_amount": 7056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7527.06, "standard_charge_percentage": 80.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8467.94, "standard_charge_percentage": 90.0000, "estimated_amount": 8467, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7997.5, "standard_charge_percentage": 85.0000, "estimated_amount": 7997, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8232.72, "standard_charge_percentage": 87.5000, "estimated_amount": 8232, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7527.06, "standard_charge_percentage": 80.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7527.06, "standard_charge_percentage": 80.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7527.06, "standard_charge_percentage": 80.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7527.06, "standard_charge_percentage": 80.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6586.17, "standard_charge_percentage": 70.0000, "estimated_amount": 6586, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7715.23, "standard_charge_percentage": 82.0000, "estimated_amount": 7715, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5268.94, "standard_charge_percentage": 56.0000, "estimated_amount": 5268, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7527.06, "standard_charge_percentage": 80.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9220.64, "standard_charge_percentage": 98.0000, "estimated_amount": 9220, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9408.82, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1627, "estimated_amount": 1627, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8467.94, "standard_charge_percentage": 90.0000, "estimated_amount": 8467, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8467.94, "standard_charge_percentage": 90.0000, "estimated_amount": 8467, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8232.72, "standard_charge_percentage": 87.5000, "estimated_amount": 8232, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7527.06, "standard_charge_percentage": 80.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9408.82, "standard_charge_percentage": 100.0000, "estimated_amount": 9408, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5645.29, "standard_charge_percentage": 60.0000, "estimated_amount": 5645, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7527.06, "standard_charge_percentage": 80.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2822.65, "standard_charge_percentage": 30.0000, "estimated_amount": 2822, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6586.17, "standard_charge_percentage": 70.0000, "estimated_amount": 6586, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7056.61, "standard_charge_percentage": 75.0000, "estimated_amount": 7056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5645.29, "standard_charge_percentage": 60.0000, "estimated_amount": 5645, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9408.82, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7056.61, "standard_charge_percentage": 75.0000, "estimated_amount": 7056, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7527.06, "standard_charge_percentage": 80.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4704.41, "standard_charge_percentage": 50.0000, "estimated_amount": 4704, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3763.53, "standard_charge_percentage": 40.0000, "estimated_amount": 3763, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9408.82, "standard_charge_percentage": 100.0000, "estimated_amount": 9408, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7056.61, "standard_charge_percentage": 75.0000, "estimated_amount": 7056, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6586.17, "standard_charge_percentage": 70.0000, "estimated_amount": 6586, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 9408.82, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4489, "estimated_amount": 4489, "methodology": "case rate" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8938.38, "standard_charge_percentage": 95.0000, "estimated_amount": 8938, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7527.06, "standard_charge_percentage": 80.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7056.61, "standard_charge_percentage": 75.0000, "estimated_amount": 7056, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5457.12, "standard_charge_percentage": 58.0000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8467.94, "standard_charge_percentage": 90.0000, "estimated_amount": 8467, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8467.94, "standard_charge_percentage": 90.0000, "estimated_amount": 8467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 9408.82, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 9408.82, "estimated_amount": 9408, "methodology": "fee schedule" }]}]} , { "description": "Hc Drain Finger Abscess Simple", "code_information": [ { "code": "26010", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1002.04, "discounted_cash": 242,"minimum": 169.39,"maximum": 1002.04,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 202.8, "estimated_amount": 202, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 876.78, "standard_charge_percentage": 87.5000, "estimated_amount": 876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 951.94, "standard_charge_percentage": 95.0000, "estimated_amount": 951, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 300.61, "standard_charge_percentage": 30.0000, "estimated_amount": 300, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 561.14, "standard_charge_percentage": 56.0000, "estimated_amount": 561, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 345.8, "estimated_amount": 345, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 181.05, "estimated_amount": 181, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 661.86, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 190.66, "estimated_amount": 190, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 373.84, "estimated_amount": 373, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 243.92, "estimated_amount": 243, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 245.62, "estimated_amount": 245, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 242.23, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 751.53, "standard_charge_percentage": 75.0000, "estimated_amount": 751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 601.22, "standard_charge_percentage": 60.0000, "estimated_amount": 601, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 196.27, "estimated_amount": 196, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 169.39, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 851.73, "standard_charge_percentage": 85.0000, "estimated_amount": 851, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 400.82, "standard_charge_percentage": 40.0000, "estimated_amount": 400, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1002.04, "standard_charge_percentage": 100.0000, "estimated_amount": 1002, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 801.63, "standard_charge_percentage": 80.0000, "estimated_amount": 801, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 701.43, "standard_charge_percentage": 70.0000, "estimated_amount": 701, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 821.67, "standard_charge_percentage": 82.0000, "estimated_amount": 821, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 581.18, "standard_charge_percentage": 58.0000, "estimated_amount": 581, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 370.75, "standard_charge_percentage": 37.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 901.84, "standard_charge_percentage": 90.0000, "estimated_amount": 901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 982, "standard_charge_percentage": 98.0000, "estimated_amount": 982, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 501.02, "standard_charge_percentage": 50.0000, "estimated_amount": 501, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 252.34, "estimated_amount": 252, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 299.07, "estimated_amount": 299, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 261.69, "estimated_amount": 261, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 186.92, "estimated_amount": 186, "methodology": "fee schedule" }]}]} , { "description": "Hc Drain Finger Abscess,Complicated", "code_information": [ { "code": "26011", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7954.36, "discounted_cash": 1981,"minimum": 525.22,"maximum": 7954.36,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7158.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7158, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6363.49, "standard_charge_percentage": 80.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7556.64, "standard_charge_percentage": 95.0000, "estimated_amount": 7556, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4772.62, "standard_charge_percentage": 60.0000, "estimated_amount": 4772, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5568.05, "standard_charge_percentage": 70.0000, "estimated_amount": 5568, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5568.05, "standard_charge_percentage": 70.0000, "estimated_amount": 5568, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5965.77, "standard_charge_percentage": 75.0000, "estimated_amount": 5965, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7158.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7158, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3977.18, "standard_charge_percentage": 50.0000, "estimated_amount": 3977, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7158.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7158, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6761.21, "standard_charge_percentage": 85.0000, "estimated_amount": 6761, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3181.74, "standard_charge_percentage": 40.0000, "estimated_amount": 3181, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6363.49, "standard_charge_percentage": 80.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2386.31, "standard_charge_percentage": 30.0000, "estimated_amount": 2386, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5965.77, "standard_charge_percentage": 75.0000, "estimated_amount": 5965, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4454.44, "standard_charge_percentage": 56.0000, "estimated_amount": 4454, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4613.53, "standard_charge_percentage": 58.0000, "estimated_amount": 4613, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5965.77, "standard_charge_percentage": 75.0000, "estimated_amount": 5965, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6363.49, "standard_charge_percentage": 80.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7158.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7158, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6960.06, "standard_charge_percentage": 87.5000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6363.49, "standard_charge_percentage": 80.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7954.36, "standard_charge_percentage": 100.0000, "estimated_amount": 7954, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6363.49, "standard_charge_percentage": 80.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6363.49, "standard_charge_percentage": 80.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5568.05, "standard_charge_percentage": 70.0000, "estimated_amount": 5568, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6363.49, "standard_charge_percentage": 80.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7795.27, "standard_charge_percentage": 98.0000, "estimated_amount": 7795, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5965.77, "standard_charge_percentage": 75.0000, "estimated_amount": 5965, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4772.62, "standard_charge_percentage": 60.0000, "estimated_amount": 4772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6363.49, "standard_charge_percentage": 80.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5965.77, "standard_charge_percentage": 75.0000, "estimated_amount": 5965, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6960.06, "standard_charge_percentage": 87.5000, "estimated_amount": 6960, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7954.36, "standard_charge_percentage": 100.0000, "estimated_amount": 7954, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6363.49, "standard_charge_percentage": 80.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6363.49, "standard_charge_percentage": 80.0000, "estimated_amount": 6363, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6522.58, "standard_charge_percentage": 82.0000, "estimated_amount": 6522, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7158.92, "standard_charge_percentage": 90.0000, "estimated_amount": 7158, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "26055", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9063.07, "discounted_cash": 1957,"minimum": 520.65,"maximum": 9063.07,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1964.62, "estimated_amount": 1964, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 520.65, "estimated_amount": 520, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1950.98, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5437.84, "standard_charge_percentage": 60.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6344.15, "standard_charge_percentage": 70.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8881.81, "standard_charge_percentage": 98.0000, "estimated_amount": 8881, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5437.84, "standard_charge_percentage": 60.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5330.88, "estimated_amount": 5330, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1535.64, "estimated_amount": 1535, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1438.25, "estimated_amount": 1438, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4531.53, "standard_charge_percentage": 50.0000, "estimated_amount": 4531, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7703.61, "standard_charge_percentage": 85.0000, "estimated_amount": 7703, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3625.23, "standard_charge_percentage": 40.0000, "estimated_amount": 3625, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7930.19, "standard_charge_percentage": 87.5000, "estimated_amount": 7930, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8609.92, "standard_charge_percentage": 95.0000, "estimated_amount": 8609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5075.32, "standard_charge_percentage": 56.0000, "estimated_amount": 5075, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5256.58, "standard_charge_percentage": 58.0000, "estimated_amount": 5256, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1978.26, "estimated_amount": 1978, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7930.19, "standard_charge_percentage": 87.5000, "estimated_amount": 7930, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9063.07, "standard_charge_percentage": 100.0000, "estimated_amount": 9063, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6344.15, "standard_charge_percentage": 70.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2032.47, "estimated_amount": 2032, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3011.06, "estimated_amount": 3011, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9063.07, "standard_charge_percentage": 100.0000, "estimated_amount": 9063, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2718.92, "standard_charge_percentage": 30.0000, "estimated_amount": 2718, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6344.15, "standard_charge_percentage": 70.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7431.72, "standard_charge_percentage": 82.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2785.23, "estimated_amount": 2785, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Metacarpal Fx W Manip Ea", "code_information": [ { "code": "26605", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1098.08, "discounted_cash": 293,"minimum": 204.5,"maximum": 1098.08,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1098.08, "estimated_amount": 1098, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 439.23, "standard_charge_percentage": 40.0000, "estimated_amount": 439, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 960.82, "standard_charge_percentage": 87.5000, "estimated_amount": 960, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 823.56, "standard_charge_percentage": 75.0000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 823.56, "standard_charge_percentage": 75.0000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 988.27, "standard_charge_percentage": 90.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 933.37, "standard_charge_percentage": 85.0000, "estimated_amount": 933, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1043.18, "standard_charge_percentage": 95.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1098.08, "standard_charge_percentage": 100.0000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 329.42, "standard_charge_percentage": 30.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 768.66, "standard_charge_percentage": 70.0000, "estimated_amount": 768, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 636.89, "standard_charge_percentage": 58.0000, "estimated_amount": 636, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 988.27, "standard_charge_percentage": 90.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 658.85, "standard_charge_percentage": 60.0000, "estimated_amount": 658, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1098.08, "standard_charge_percentage": 100.0000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 823.56, "standard_charge_percentage": 75.0000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 768.66, "standard_charge_percentage": 70.0000, "estimated_amount": 768, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 823.56, "standard_charge_percentage": 75.0000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 406.29, "standard_charge_percentage": 37.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 823.56, "standard_charge_percentage": 75.0000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 549.04, "standard_charge_percentage": 50.0000, "estimated_amount": 549, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 988.27, "standard_charge_percentage": 90.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 988.27, "standard_charge_percentage": 90.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 960.82, "standard_charge_percentage": 87.5000, "estimated_amount": 960, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 658.85, "standard_charge_percentage": 60.0000, "estimated_amount": 658, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 768.66, "standard_charge_percentage": 70.0000, "estimated_amount": 768, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 900.43, "standard_charge_percentage": 82.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 614.92, "standard_charge_percentage": 56.0000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 988.27, "standard_charge_percentage": 90.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1076.12, "standard_charge_percentage": 98.0000, "estimated_amount": 1076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Thumb Disloc W Manip", "code_information": [ { "code": "26641", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Mc-P Disloc W Manip Wo Anes", "code_information": [ { "code": "26700", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 76.39,"maximum": 1150.1,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 76.39, "estimated_amount": 76, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Prox/Mid Fing Shft Fx W Manip Ea", "code_information": [ { "code": "26725", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1098.08, "discounted_cash": 293,"minimum": 204.5,"maximum": 1098.08,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 988.27, "standard_charge_percentage": 90.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 439.23, "standard_charge_percentage": 40.0000, "estimated_amount": 439, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 960.82, "standard_charge_percentage": 87.5000, "estimated_amount": 960, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 960.82, "standard_charge_percentage": 87.5000, "estimated_amount": 960, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1043.18, "standard_charge_percentage": 95.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 658.85, "standard_charge_percentage": 60.0000, "estimated_amount": 658, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 823.56, "standard_charge_percentage": 75.0000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 823.56, "standard_charge_percentage": 75.0000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 823.56, "standard_charge_percentage": 75.0000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 549.04, "standard_charge_percentage": 50.0000, "estimated_amount": 549, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 933.37, "standard_charge_percentage": 85.0000, "estimated_amount": 933, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1098.08, "standard_charge_percentage": 100.0000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 329.42, "standard_charge_percentage": 30.0000, "estimated_amount": 329, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 768.66, "standard_charge_percentage": 70.0000, "estimated_amount": 768, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 614.92, "standard_charge_percentage": 56.0000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 636.89, "standard_charge_percentage": 58.0000, "estimated_amount": 636, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 988.27, "standard_charge_percentage": 90.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 988.27, "standard_charge_percentage": 90.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 658.85, "standard_charge_percentage": 60.0000, "estimated_amount": 658, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 988.27, "standard_charge_percentage": 90.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 988.27, "standard_charge_percentage": 90.0000, "estimated_amount": 988, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 900.43, "standard_charge_percentage": 82.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1076.12, "standard_charge_percentage": 98.0000, "estimated_amount": 1076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1098.08, "estimated_amount": 1098, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 823.56, "standard_charge_percentage": 75.0000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 878.46, "standard_charge_percentage": 80.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1098.08, "standard_charge_percentage": 100.0000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 823.56, "standard_charge_percentage": 75.0000, "estimated_amount": 823, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 768.66, "standard_charge_percentage": 70.0000, "estimated_amount": 768, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 768.66, "standard_charge_percentage": 70.0000, "estimated_amount": 768, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 406.29, "standard_charge_percentage": 37.0000, "estimated_amount": 406, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Fingr Articular Fx W Manip Ea", "code_information": [ { "code": "26742", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7772.08, "discounted_cash": 1957,"minimum": 520.65,"maximum": 7772.08,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1438.25, "estimated_amount": 1438, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6606.27, "standard_charge_percentage": 85.0000, "estimated_amount": 6606, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6800.57, "standard_charge_percentage": 87.5000, "estimated_amount": 6800, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2785.23, "estimated_amount": 2785, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 520.65, "estimated_amount": 520, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7383.48, "standard_charge_percentage": 95.0000, "estimated_amount": 7383, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7772.08, "standard_charge_percentage": 100.0000, "estimated_amount": 7772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2331.62, "standard_charge_percentage": 30.0000, "estimated_amount": 2331, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6373.11, "standard_charge_percentage": 82.0000, "estimated_amount": 6373, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4507.81, "standard_charge_percentage": 58.0000, "estimated_amount": 4507, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5330.88, "estimated_amount": 5330, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1535.64, "estimated_amount": 1535, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1978.26, "estimated_amount": 1978, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1950.98, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3886.04, "standard_charge_percentage": 50.0000, "estimated_amount": 3886, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3108.83, "standard_charge_percentage": 40.0000, "estimated_amount": 3108, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6800.57, "standard_charge_percentage": 87.5000, "estimated_amount": 6800, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7772.08, "standard_charge_percentage": 100.0000, "estimated_amount": 7772, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4663.25, "standard_charge_percentage": 60.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4352.36, "standard_charge_percentage": 56.0000, "estimated_amount": 4352, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2875.67, "standard_charge_percentage": 37.0000, "estimated_amount": 2875, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7616.64, "standard_charge_percentage": 98.0000, "estimated_amount": 7616, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1964.62, "estimated_amount": 1964, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4663.25, "standard_charge_percentage": 60.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2032.47, "estimated_amount": 2032, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3011.06, "estimated_amount": 3011, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Ip Jnt Disloc W Manip Wo Anes", "code_information": [ { "code": "26770", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "27062", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9063.07, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 9063.07,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4531.53, "standard_charge_percentage": 50.0000, "estimated_amount": 4531, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7703.61, "standard_charge_percentage": 85.0000, "estimated_amount": 7703, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8609.92, "standard_charge_percentage": 95.0000, "estimated_amount": 8609, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9063.07, "standard_charge_percentage": 100.0000, "estimated_amount": 9063, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6344.15, "standard_charge_percentage": 70.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4489, "estimated_amount": 4489, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5437.84, "standard_charge_percentage": 60.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6344.15, "standard_charge_percentage": 70.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7431.72, "standard_charge_percentage": 82.0000, "estimated_amount": 7431, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8881.81, "standard_charge_percentage": 98.0000, "estimated_amount": 8881, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3625.23, "standard_charge_percentage": 40.0000, "estimated_amount": 3625, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7930.19, "standard_charge_percentage": 87.5000, "estimated_amount": 7930, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5075.32, "standard_charge_percentage": 56.0000, "estimated_amount": 5075, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1627, "estimated_amount": 1627, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7930.19, "standard_charge_percentage": 87.5000, "estimated_amount": 7930, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9063.07, "standard_charge_percentage": 100.0000, "estimated_amount": 9063, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2718.92, "standard_charge_percentage": 30.0000, "estimated_amount": 2718, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6344.15, "standard_charge_percentage": 70.0000, "estimated_amount": 6344, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6797.3, "standard_charge_percentage": 75.0000, "estimated_amount": 6797, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5256.58, "standard_charge_percentage": 58.0000, "estimated_amount": 5256, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7250.46, "standard_charge_percentage": 80.0000, "estimated_amount": 7250, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8156.76, "standard_charge_percentage": 90.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5437.84, "standard_charge_percentage": 60.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9063.07, "estimated_amount": 9063, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" }]}]} , { "description": "Hc Arthro Hip Wo Anesth", "code_information": [ { "code": "27093", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1302.26,"minimum": 83.82,"maximum": 1302.26,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1139.48, "standard_charge_percentage": 87.5000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1067.85, "standard_charge_percentage": 82.0000, "estimated_amount": 1067, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 781.36, "standard_charge_percentage": 60.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1302.26, "estimated_amount": 1302, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 651.13, "standard_charge_percentage": 50.0000, "estimated_amount": 651, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 781.36, "standard_charge_percentage": 60.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 755.31, "standard_charge_percentage": 58.0000, "estimated_amount": 755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 83.82, "estimated_amount": 83, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1237.15, "standard_charge_percentage": 95.0000, "estimated_amount": 1237, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 729.27, "standard_charge_percentage": 56.0000, "estimated_amount": 729, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 481.84, "standard_charge_percentage": 37.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1106.92, "standard_charge_percentage": 85.0000, "estimated_amount": 1106, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 520.9, "standard_charge_percentage": 40.0000, "estimated_amount": 520, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1139.48, "standard_charge_percentage": 87.5000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1302.26, "standard_charge_percentage": 100.0000, "estimated_amount": 1302, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1302.26, "standard_charge_percentage": 100.0000, "estimated_amount": 1302, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 390.68, "standard_charge_percentage": 30.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1276.21, "standard_charge_percentage": 98.0000, "estimated_amount": 1276, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Injection Hip Arthrogram,Anesth", "code_information": [ { "code": "27095", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1302.26,"minimum": 390.68,"maximum": 1302.26,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 416, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1302.26, "estimated_amount": 1302, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1139.48, "standard_charge_percentage": 87.5000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 781.36, "standard_charge_percentage": 60.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1067.85, "standard_charge_percentage": 82.0000, "estimated_amount": 1067, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 481.84, "standard_charge_percentage": 37.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 520.9, "standard_charge_percentage": 40.0000, "estimated_amount": 520, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 390.68, "standard_charge_percentage": 30.0000, "estimated_amount": 390, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 911.58, "standard_charge_percentage": 70.0000, "estimated_amount": 911, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 651.13, "standard_charge_percentage": 50.0000, "estimated_amount": 651, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1106.92, "standard_charge_percentage": 85.0000, "estimated_amount": 1106, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1302.26, "standard_charge_percentage": 100.0000, "estimated_amount": 1302, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1302.26, "standard_charge_percentage": 100.0000, "estimated_amount": 1302, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 729.27, "standard_charge_percentage": 56.0000, "estimated_amount": 729, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 755.31, "standard_charge_percentage": 58.0000, "estimated_amount": 755, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1139.48, "standard_charge_percentage": 87.5000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1237.15, "standard_charge_percentage": 95.0000, "estimated_amount": 1237, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1041.81, "standard_charge_percentage": 80.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1172.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1172, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1276.21, "standard_charge_percentage": 98.0000, "estimated_amount": 1276, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 976.7, "standard_charge_percentage": 75.0000, "estimated_amount": 976, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 781.36, "standard_charge_percentage": 60.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Injection Sacroiliac Jnt, Stroid/Anes Agent", "code_information": [ { "code": "27096", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1171.48,"minimum": 104,"maximum": 1171.48,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 104, "estimated_amount": 104, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 937.18, "standard_charge_percentage": 80.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1054.33, "standard_charge_percentage": 90.0000, "estimated_amount": 1054, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 995.76, "standard_charge_percentage": 85.0000, "estimated_amount": 995, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1025.05, "standard_charge_percentage": 87.5000, "estimated_amount": 1025, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1112.91, "standard_charge_percentage": 95.0000, "estimated_amount": 1112, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 937.18, "standard_charge_percentage": 80.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 937.18, "standard_charge_percentage": 80.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 937.18, "standard_charge_percentage": 80.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 878.61, "standard_charge_percentage": 75.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 878.61, "standard_charge_percentage": 75.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 656.03, "standard_charge_percentage": 56.0000, "estimated_amount": 656, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 679.46, "standard_charge_percentage": 58.0000, "estimated_amount": 679, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 878.61, "standard_charge_percentage": 75.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 702.89, "standard_charge_percentage": 60.0000, "estimated_amount": 702, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1171.48, "estimated_amount": 1171, "methodology": "case rate" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 937.18, "standard_charge_percentage": 80.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 937.18, "standard_charge_percentage": 80.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 351.44, "standard_charge_percentage": 30.0000, "estimated_amount": 351, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 820.04, "standard_charge_percentage": 70.0000, "estimated_amount": 820, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 820.04, "standard_charge_percentage": 70.0000, "estimated_amount": 820, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1054.33, "standard_charge_percentage": 90.0000, "estimated_amount": 1054, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1054.33, "standard_charge_percentage": 90.0000, "estimated_amount": 1054, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 937.18, "standard_charge_percentage": 80.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1054.33, "standard_charge_percentage": 90.0000, "estimated_amount": 1054, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1025.05, "standard_charge_percentage": 87.5000, "estimated_amount": 1025, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 702.89, "standard_charge_percentage": 60.0000, "estimated_amount": 702, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 820.04, "standard_charge_percentage": 70.0000, "estimated_amount": 820, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 960.61, "standard_charge_percentage": 82.0000, "estimated_amount": 960, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 878.61, "standard_charge_percentage": 75.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 878.61, "standard_charge_percentage": 75.0000, "estimated_amount": 878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 585.74, "standard_charge_percentage": 50.0000, "estimated_amount": 585, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1054.33, "standard_charge_percentage": 90.0000, "estimated_amount": 1054, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 468.59, "standard_charge_percentage": 40.0000, "estimated_amount": 468, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 937.18, "standard_charge_percentage": 80.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1171.48, "standard_charge_percentage": 100.0000, "estimated_amount": 1171, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1171.48, "standard_charge_percentage": 100.0000, "estimated_amount": 1171, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 937.18, "standard_charge_percentage": 80.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 433.45, "standard_charge_percentage": 37.0000, "estimated_amount": 433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 937.18, "standard_charge_percentage": 80.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1148.05, "standard_charge_percentage": 98.0000, "estimated_amount": 1148, "methodology": "percent of total billed charges" }]}]} , { "description": "Total hip arthroplasty", "code_information": [ { "code": "27130", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 22225, "discounted_cash": 15735,"minimum": 5440,"maximum": 22225,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 10968.7, "estimated_amount": 10968, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5440, "estimated_amount": 5440, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 17780, "standard_charge_percentage": 80.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 16668.8, "standard_charge_percentage": 75.0000, "estimated_amount": 16668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 11112.5, "standard_charge_percentage": 50.0000, "estimated_amount": 11112, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 20002.5, "standard_charge_percentage": 90.0000, "estimated_amount": 20002, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 19446.9, "standard_charge_percentage": 87.5000, "estimated_amount": 19446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 17780, "standard_charge_percentage": 80.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 17780, "standard_charge_percentage": 80.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 17780, "standard_charge_percentage": 80.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 17780, "standard_charge_percentage": 80.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 16668.8, "standard_charge_percentage": 75.0000, "estimated_amount": 16668, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 15557.5, "standard_charge_percentage": 70.0000, "estimated_amount": 15557, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 21780.5, "standard_charge_percentage": 98.0000, "estimated_amount": 21780, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 16340.5, "estimated_amount": 16340, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 13082, "estimated_amount": 13082, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 8509.01, "estimated_amount": 8509, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 20002.5, "standard_charge_percentage": 90.0000, "estimated_amount": 20002, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 20002.5, "standard_charge_percentage": 90.0000, "estimated_amount": 20002, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 8890, "standard_charge_percentage": 40.0000, "estimated_amount": 8890, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 17780, "standard_charge_percentage": 80.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 22225, "standard_charge_percentage": 100.0000, "estimated_amount": 22225, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6667.5, "standard_charge_percentage": 30.0000, "estimated_amount": 6667, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 18224.5, "standard_charge_percentage": 82.0000, "estimated_amount": 18224, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 12446, "standard_charge_percentage": 56.0000, "estimated_amount": 12446, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 12890.5, "standard_charge_percentage": 58.0000, "estimated_amount": 12890, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 16668.8, "standard_charge_percentage": 75.0000, "estimated_amount": 16668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 13335, "standard_charge_percentage": 60.0000, "estimated_amount": 13335, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 22225, "estimated_amount": 22225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 19366.5, "estimated_amount": 19366, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 22225, "estimated_amount": 22225, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 10968.7, "estimated_amount": 10968, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 17780, "standard_charge_percentage": 80.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 18891.3, "standard_charge_percentage": 85.0000, "estimated_amount": 18891, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 22225, "standard_charge_percentage": 100.0000, "estimated_amount": 22225, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 17780, "standard_charge_percentage": 80.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 15557.5, "standard_charge_percentage": 70.0000, "estimated_amount": 15557, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 15557.5, "standard_charge_percentage": 70.0000, "estimated_amount": 15557, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 8223.25, "standard_charge_percentage": 37.0000, "estimated_amount": 8223, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 20002.5, "standard_charge_percentage": 90.0000, "estimated_amount": 20002, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 20002.5, "standard_charge_percentage": 90.0000, "estimated_amount": 20002, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 12709.3, "estimated_amount": 12709, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 12346.2, "estimated_amount": 12346, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 19366.5, "estimated_amount": 19366, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 12709.3, "estimated_amount": 12709, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 15795, "estimated_amount": 15794, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 15904.6, "estimated_amount": 15904, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 15685.3, "estimated_amount": 15685, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 16668.8, "standard_charge_percentage": 75.0000, "estimated_amount": 16668, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 19446.9, "standard_charge_percentage": 87.5000, "estimated_amount": 19446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 17780, "standard_charge_percentage": 80.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 21113.8, "standard_charge_percentage": 95.0000, "estimated_amount": 21113, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 13335, "standard_charge_percentage": 60.0000, "estimated_amount": 13335, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 16668.8, "standard_charge_percentage": 75.0000, "estimated_amount": 16668, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 17780, "standard_charge_percentage": 80.0000, "estimated_amount": 17780, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 16945.7, "estimated_amount": 16945, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 22225, "estimated_amount": 22225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 16945.7, "estimated_amount": 16945, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "27245", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6029.09,"minimum": 312,"maximum": 6029.09,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4823.27, "standard_charge_percentage": 80.0000, "estimated_amount": 4823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3014.55, "standard_charge_percentage": 50.0000, "estimated_amount": 3014, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5275.45, "standard_charge_percentage": 87.5000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5275.45, "standard_charge_percentage": 87.5000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4823.27, "standard_charge_percentage": 80.0000, "estimated_amount": 4823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4823.27, "standard_charge_percentage": 80.0000, "estimated_amount": 4823, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3376.29, "standard_charge_percentage": 56.0000, "estimated_amount": 3376, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5426.18, "standard_charge_percentage": 90.0000, "estimated_amount": 5426, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5426.18, "standard_charge_percentage": 90.0000, "estimated_amount": 5426, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5727.64, "standard_charge_percentage": 95.0000, "estimated_amount": 5727, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3617.45, "standard_charge_percentage": 60.0000, "estimated_amount": 3617, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4823.27, "standard_charge_percentage": 80.0000, "estimated_amount": 4823, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1808.73, "standard_charge_percentage": 30.0000, "estimated_amount": 1808, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4521.82, "standard_charge_percentage": 75.0000, "estimated_amount": 4521, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4220.36, "standard_charge_percentage": 70.0000, "estimated_amount": 4220, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3617.45, "standard_charge_percentage": 60.0000, "estimated_amount": 3617, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 715.3, "estimated_amount": 715, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4521.82, "standard_charge_percentage": 75.0000, "estimated_amount": 4521, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5426.18, "standard_charge_percentage": 90.0000, "estimated_amount": 5426, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5426.18, "standard_charge_percentage": 90.0000, "estimated_amount": 5426, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 6029.09, "standard_charge_percentage": 100.0000, "estimated_amount": 6029, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4823.27, "standard_charge_percentage": 80.0000, "estimated_amount": 4823, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4220.36, "standard_charge_percentage": 70.0000, "estimated_amount": 4220, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4521.82, "standard_charge_percentage": 75.0000, "estimated_amount": 4521, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4943.85, "standard_charge_percentage": 82.0000, "estimated_amount": 4943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3496.87, "standard_charge_percentage": 58.0000, "estimated_amount": 3496, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 643.77, "estimated_amount": 643, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4489, "estimated_amount": 4489, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4521.82, "standard_charge_percentage": 75.0000, "estimated_amount": 4521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4823.27, "standard_charge_percentage": 80.0000, "estimated_amount": 4823, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5426.18, "standard_charge_percentage": 90.0000, "estimated_amount": 5426, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5124.73, "standard_charge_percentage": 85.0000, "estimated_amount": 5124, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2411.64, "standard_charge_percentage": 40.0000, "estimated_amount": 2411, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4823.27, "standard_charge_percentage": 80.0000, "estimated_amount": 4823, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4823.27, "standard_charge_percentage": 80.0000, "estimated_amount": 4823, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 6029.09, "standard_charge_percentage": 100.0000, "estimated_amount": 6029, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4823.27, "standard_charge_percentage": 80.0000, "estimated_amount": 4823, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4220.36, "standard_charge_percentage": 70.0000, "estimated_amount": 4220, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2230.76, "standard_charge_percentage": 37.0000, "estimated_amount": 2230, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4823.27, "standard_charge_percentage": 80.0000, "estimated_amount": 4823, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5908.51, "standard_charge_percentage": 98.0000, "estimated_amount": 5908, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4521.82, "standard_charge_percentage": 75.0000, "estimated_amount": 4521, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Traumatic Hip Disloc Wo Anes", "code_information": [ { "code": "27250", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 416, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Post Hip Arthrplas Disloc W Anes", "code_information": [ { "code": "27265", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" }]}]} , { "description": "Hc I&D Thigh/Knee Abscess,Deep", "code_information": [ { "code": "27301", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 13942.9, "discounted_cash": 3500,"minimum": 920.5,"maximum": 13942.9,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3513.37, "estimated_amount": 3513, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2589.97, "estimated_amount": 2589, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3537.77, "estimated_amount": 3537, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6971.45, "standard_charge_percentage": 50.0000, "estimated_amount": 6971, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5577.16, "standard_charge_percentage": 40.0000, "estimated_amount": 5577, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 13942.9, "standard_charge_percentage": 100.0000, "estimated_amount": 13942, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 13245.8, "standard_charge_percentage": 95.0000, "estimated_amount": 13245, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 9760.03, "standard_charge_percentage": 70.0000, "estimated_amount": 9760, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 8086.88, "standard_charge_percentage": 58.0000, "estimated_amount": 8086, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 12548.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12548, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 10457.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 8365.74, "standard_charge_percentage": 60.0000, "estimated_amount": 8365, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 10457.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10457, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 12548.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12548, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 11851.5, "standard_charge_percentage": 85.0000, "estimated_amount": 11851, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 10457.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10457, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 7808.02, "standard_charge_percentage": 56.0000, "estimated_amount": 7808, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 13664, "standard_charge_percentage": 98.0000, "estimated_amount": 13664, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9533.36, "estimated_amount": 9533, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2746.23, "estimated_amount": 2746, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 12548.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12548, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 12548.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12548, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 12200, "standard_charge_percentage": 87.5000, "estimated_amount": 12200, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 12200, "standard_charge_percentage": 87.5000, "estimated_amount": 12200, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 13942.9, "standard_charge_percentage": 100.0000, "estimated_amount": 13942, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 11154.3, "standard_charge_percentage": 80.0000, "estimated_amount": 11154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4182.87, "standard_charge_percentage": 30.0000, "estimated_amount": 4182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 10457.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10457, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 9760.03, "standard_charge_percentage": 70.0000, "estimated_amount": 9760, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 9760.03, "standard_charge_percentage": 70.0000, "estimated_amount": 9760, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 11433.2, "standard_charge_percentage": 82.0000, "estimated_amount": 11433, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 920.5, "estimated_amount": 920, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3488.97, "estimated_amount": 3488, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 10457.2, "standard_charge_percentage": 75.0000, "estimated_amount": 10457, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 8365.74, "standard_charge_percentage": 60.0000, "estimated_amount": 8365, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 12548.6, "standard_charge_percentage": 90.0000, "estimated_amount": 12548, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3634.71, "estimated_amount": 3634, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4980.9, "estimated_amount": 4980, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5384.76, "estimated_amount": 5384, "methodology": "fee schedule" }]}]} , { "description": "Removal of kneecap", "code_information": [ { "code": "27350", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 25630.5, "discounted_cash": 8736,"minimum": 1403,"maximum": 25630.5,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 19222.9, "standard_charge_percentage": 75.0000, "estimated_amount": 19222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 20504.4, "standard_charge_percentage": 80.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 21785.9, "standard_charge_percentage": 85.0000, "estimated_amount": 21785, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 10252.2, "standard_charge_percentage": 40.0000, "estimated_amount": 10252, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 20504.4, "standard_charge_percentage": 80.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 20504.4, "standard_charge_percentage": 80.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 17941.3, "standard_charge_percentage": 70.0000, "estimated_amount": 17941, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 19222.9, "standard_charge_percentage": 75.0000, "estimated_amount": 19222, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 23067.5, "standard_charge_percentage": 90.0000, "estimated_amount": 23067, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13440.5, "estimated_amount": 13440, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 19222.9, "standard_charge_percentage": 75.0000, "estimated_amount": 19222, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 25630.5, "standard_charge_percentage": 100.0000, "estimated_amount": 25630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 20504.4, "standard_charge_percentage": 80.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 25117.9, "standard_charge_percentage": 98.0000, "estimated_amount": 25117, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 23795.5, "estimated_amount": 23795, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1403, "estimated_amount": 1403, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 23067.5, "standard_charge_percentage": 90.0000, "estimated_amount": 23067, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 23067.5, "standard_charge_percentage": 90.0000, "estimated_amount": 23067, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 22426.7, "standard_charge_percentage": 87.5000, "estimated_amount": 22426, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 22426.7, "standard_charge_percentage": 87.5000, "estimated_amount": 22426, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 20504.4, "standard_charge_percentage": 80.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 24349, "standard_charge_percentage": 95.0000, "estimated_amount": 24348, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 25630.5, "standard_charge_percentage": 100.0000, "estimated_amount": 25630, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 20504.4, "standard_charge_percentage": 80.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7689.15, "standard_charge_percentage": 30.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 19222.9, "standard_charge_percentage": 75.0000, "estimated_amount": 19222, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 23067.5, "standard_charge_percentage": 90.0000, "estimated_amount": 23067, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 20504.4, "standard_charge_percentage": 80.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 12815.3, "standard_charge_percentage": 50.0000, "estimated_amount": 12815, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 23067.5, "standard_charge_percentage": 90.0000, "estimated_amount": 23067, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 20504.4, "standard_charge_percentage": 80.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 15378.3, "standard_charge_percentage": 60.0000, "estimated_amount": 15378, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 20504.4, "standard_charge_percentage": 80.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 17941.3, "standard_charge_percentage": 70.0000, "estimated_amount": 17941, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 17941.3, "standard_charge_percentage": 70.0000, "estimated_amount": 17941, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 21017, "standard_charge_percentage": 82.0000, "estimated_amount": 21017, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 14353.1, "standard_charge_percentage": 56.0000, "estimated_amount": 14353, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 14865.7, "standard_charge_percentage": 58.0000, "estimated_amount": 14865, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 20504.4, "standard_charge_percentage": 80.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 19222.9, "standard_charge_percentage": 75.0000, "estimated_amount": 19222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 15378.3, "standard_charge_percentage": 60.0000, "estimated_amount": 15378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" }]}]} , { "description": "Hc Njx Px Cntrst Kne Arthg Cntrst Enhncd Ct/Mri Kne", "code_information": [ { "code": "27369", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 506.1,"minimum": 151.83,"maximum": 506.1,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 404.88, "standard_charge_percentage": 80.0000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 506.1, "standard_charge_percentage": 100.0000, "estimated_amount": 506, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 404.88, "standard_charge_percentage": 80.0000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 293.54, "standard_charge_percentage": 58.0000, "estimated_amount": 293, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 455.49, "standard_charge_percentage": 90.0000, "estimated_amount": 455, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 379.57, "standard_charge_percentage": 75.0000, "estimated_amount": 379, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 379.57, "standard_charge_percentage": 75.0000, "estimated_amount": 379, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 404.88, "standard_charge_percentage": 80.0000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 455.49, "standard_charge_percentage": 90.0000, "estimated_amount": 455, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 455.49, "standard_charge_percentage": 90.0000, "estimated_amount": 455, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 442.84, "standard_charge_percentage": 87.5000, "estimated_amount": 442, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 404.88, "standard_charge_percentage": 80.0000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 151.83, "standard_charge_percentage": 30.0000, "estimated_amount": 151, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 354.27, "standard_charge_percentage": 70.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 379.57, "standard_charge_percentage": 75.0000, "estimated_amount": 379, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 253.05, "standard_charge_percentage": 50.0000, "estimated_amount": 253, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 442.84, "standard_charge_percentage": 87.5000, "estimated_amount": 442, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 404.88, "standard_charge_percentage": 80.0000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 506.1, "standard_charge_percentage": 100.0000, "estimated_amount": 506, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 480.8, "standard_charge_percentage": 95.0000, "estimated_amount": 480, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 379.57, "standard_charge_percentage": 75.0000, "estimated_amount": 379, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 283.42, "standard_charge_percentage": 56.0000, "estimated_amount": 283, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 187.26, "standard_charge_percentage": 37.0000, "estimated_amount": 187, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 404.88, "standard_charge_percentage": 80.0000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 455.49, "standard_charge_percentage": 90.0000, "estimated_amount": 455, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 495.98, "standard_charge_percentage": 98.0000, "estimated_amount": 495, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 379.57, "standard_charge_percentage": 75.0000, "estimated_amount": 379, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 303.66, "standard_charge_percentage": 60.0000, "estimated_amount": 303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 506.1, "estimated_amount": 506, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 455.49, "standard_charge_percentage": 90.0000, "estimated_amount": 455, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 430.19, "standard_charge_percentage": 85.0000, "estimated_amount": 430, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 202.44, "standard_charge_percentage": 40.0000, "estimated_amount": 202, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 404.88, "standard_charge_percentage": 80.0000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 404.88, "standard_charge_percentage": 80.0000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 303.66, "standard_charge_percentage": 60.0000, "estimated_amount": 303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 404.88, "standard_charge_percentage": 80.0000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 404.88, "standard_charge_percentage": 80.0000, "estimated_amount": 404, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 354.27, "standard_charge_percentage": 70.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 354.27, "standard_charge_percentage": 70.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 415, "standard_charge_percentage": 82.0000, "estimated_amount": 415, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "27427", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19359.8, "discounted_cash": 8736,"minimum": 1123,"maximum": 19359.8,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9679.92, "standard_charge_percentage": 50.0000, "estimated_amount": 9679, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7743.94, "standard_charge_percentage": 40.0000, "estimated_amount": 7743, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 15487.9, "standard_charge_percentage": 80.0000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 11615.9, "standard_charge_percentage": 60.0000, "estimated_amount": 11615, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15487.9, "standard_charge_percentage": 80.0000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 15487.9, "standard_charge_percentage": 80.0000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 15487.9, "standard_charge_percentage": 80.0000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5807.95, "standard_charge_percentage": 30.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 14519.9, "standard_charge_percentage": 75.0000, "estimated_amount": 14519, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 13551.9, "standard_charge_percentage": 70.0000, "estimated_amount": 13551, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 11228.7, "standard_charge_percentage": 58.0000, "estimated_amount": 11228, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 14519.9, "standard_charge_percentage": 75.0000, "estimated_amount": 14519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13440.5, "estimated_amount": 13440, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 15487.9, "standard_charge_percentage": 80.0000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 17423.9, "standard_charge_percentage": 90.0000, "estimated_amount": 17423, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 17423.9, "standard_charge_percentage": 90.0000, "estimated_amount": 17423, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 15487.9, "standard_charge_percentage": 80.0000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 15487.9, "standard_charge_percentage": 80.0000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 19359.8, "standard_charge_percentage": 100.0000, "estimated_amount": 19359, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 18391.9, "standard_charge_percentage": 95.0000, "estimated_amount": 18391, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 15487.9, "standard_charge_percentage": 80.0000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 13551.9, "standard_charge_percentage": 70.0000, "estimated_amount": 13551, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 13551.9, "standard_charge_percentage": 70.0000, "estimated_amount": 13551, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 15875.1, "standard_charge_percentage": 82.0000, "estimated_amount": 15875, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15487.9, "standard_charge_percentage": 80.0000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 17423.9, "standard_charge_percentage": 90.0000, "estimated_amount": 17423, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 19359.8, "estimated_amount": 19359, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 14519.9, "standard_charge_percentage": 75.0000, "estimated_amount": 14519, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15487.9, "standard_charge_percentage": 80.0000, "estimated_amount": 15487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 19359.8, "standard_charge_percentage": 100.0000, "estimated_amount": 19359, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 14519.9, "standard_charge_percentage": 75.0000, "estimated_amount": 14519, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 17423.9, "standard_charge_percentage": 90.0000, "estimated_amount": 17423, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 18972.7, "standard_charge_percentage": 98.0000, "estimated_amount": 18972, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 11615.9, "standard_charge_percentage": 60.0000, "estimated_amount": 11615, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 14519.9, "standard_charge_percentage": 75.0000, "estimated_amount": 14519, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 17423.9, "standard_charge_percentage": 90.0000, "estimated_amount": 17423, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 16455.9, "standard_charge_percentage": 85.0000, "estimated_amount": 16455, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 16939.9, "standard_charge_percentage": 87.5000, "estimated_amount": 16939, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 16939.9, "standard_charge_percentage": 87.5000, "estimated_amount": 16939, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10841.5, "standard_charge_percentage": 56.0000, "estimated_amount": 10841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" }]}]} , { "description": "Total knee arthroplasty", "code_information": [ { "code": "27447", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 21074.9, "discounted_cash": 15735,"minimum": 4263.54,"maximum": 21074.9,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 13082, "estimated_amount": 13082, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 10968.7, "estimated_amount": 10968, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 15806.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15806, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 16859.9, "standard_charge_percentage": 80.0000, "estimated_amount": 16859, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 16859.9, "standard_charge_percentage": 80.0000, "estimated_amount": 16859, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 21074.9, "standard_charge_percentage": 100.0000, "estimated_amount": 21074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 20021.2, "standard_charge_percentage": 95.0000, "estimated_amount": 20021, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 12644.9, "standard_charge_percentage": 60.0000, "estimated_amount": 12644, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 16859.9, "standard_charge_percentage": 80.0000, "estimated_amount": 16859, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 16859.9, "standard_charge_percentage": 80.0000, "estimated_amount": 16859, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 17281.4, "standard_charge_percentage": 82.0000, "estimated_amount": 17281, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 11801.9, "standard_charge_percentage": 56.0000, "estimated_amount": 11801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16859.9, "standard_charge_percentage": 80.0000, "estimated_amount": 16859, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 20653.4, "standard_charge_percentage": 98.0000, "estimated_amount": 20653, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 15806.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15806, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 12346.2, "estimated_amount": 12346, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 16340.5, "estimated_amount": 16340, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 16945.7, "estimated_amount": 16945, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5440, "estimated_amount": 5440, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16859.9, "standard_charge_percentage": 80.0000, "estimated_amount": 16859, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 8429.96, "standard_charge_percentage": 40.0000, "estimated_amount": 8429, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 16859.9, "standard_charge_percentage": 80.0000, "estimated_amount": 16859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16859.9, "standard_charge_percentage": 80.0000, "estimated_amount": 16859, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 16859.9, "standard_charge_percentage": 80.0000, "estimated_amount": 16859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6322.47, "standard_charge_percentage": 30.0000, "estimated_amount": 6322, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 15806.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15806, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 14752.4, "standard_charge_percentage": 70.0000, "estimated_amount": 14752, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 15806.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15806, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 12223.4, "standard_charge_percentage": 58.0000, "estimated_amount": 12223, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 18967.4, "standard_charge_percentage": 90.0000, "estimated_amount": 18967, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 16945.7, "estimated_amount": 16945, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 12709.3, "estimated_amount": 12709, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 19366.5, "estimated_amount": 19366, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 10968.7, "estimated_amount": 10968, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 10537.5, "standard_charge_percentage": 50.0000, "estimated_amount": 10537, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 18967.4, "standard_charge_percentage": 90.0000, "estimated_amount": 18967, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 17913.7, "standard_charge_percentage": 85.0000, "estimated_amount": 17913, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 18440.5, "standard_charge_percentage": 87.5000, "estimated_amount": 18440, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 18440.5, "standard_charge_percentage": 87.5000, "estimated_amount": 18440, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 14752.4, "standard_charge_percentage": 70.0000, "estimated_amount": 14752, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 18967.4, "standard_charge_percentage": 90.0000, "estimated_amount": 18967, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 12644.9, "standard_charge_percentage": 60.0000, "estimated_amount": 12644, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 21074.9, "estimated_amount": 21074, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 15795, "estimated_amount": 15794, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4263.54, "estimated_amount": 4263, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 15904.6, "estimated_amount": 15904, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 15685.3, "estimated_amount": 15685, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 15806.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15806, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 18967.4, "standard_charge_percentage": 90.0000, "estimated_amount": 18967, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 18967.4, "standard_charge_percentage": 90.0000, "estimated_amount": 18967, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 16859.9, "standard_charge_percentage": 80.0000, "estimated_amount": 16859, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 21074.9, "standard_charge_percentage": 100.0000, "estimated_amount": 21074, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 14752.4, "standard_charge_percentage": 70.0000, "estimated_amount": 14752, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 7797.71, "standard_charge_percentage": 37.0000, "estimated_amount": 7797, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 12709.3, "estimated_amount": 12709, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 19366.5, "estimated_amount": 19366, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 21074.9, "estimated_amount": 21074, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 21074.9, "estimated_amount": 21074, "methodology": "fee schedule" }]}]} , { "description": "Revise/Replace Knee Joint", "code_information": [ { "code": "27487", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 34419.8,"minimum": 5440,"maximum": 34419.8,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 25814.8, "standard_charge_percentage": 75.0000, "estimated_amount": 25814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 27535.8, "standard_charge_percentage": 80.0000, "estimated_amount": 27535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 30117.3, "standard_charge_percentage": 87.5000, "estimated_amount": 30117, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 27535.8, "standard_charge_percentage": 80.0000, "estimated_amount": 27535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 34419.8, "standard_charge_percentage": 100.0000, "estimated_amount": 34419, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 27535.8, "standard_charge_percentage": 80.0000, "estimated_amount": 27535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10325.9, "standard_charge_percentage": 30.0000, "estimated_amount": 10325, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 12735.3, "standard_charge_percentage": 37.0000, "estimated_amount": 12735, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 27535.8, "standard_charge_percentage": 80.0000, "estimated_amount": 27535, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 30977.8, "standard_charge_percentage": 90.0000, "estimated_amount": 30977, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 33731.4, "standard_charge_percentage": 98.0000, "estimated_amount": 33731, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 27535.8, "standard_charge_percentage": 80.0000, "estimated_amount": 27535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 17209.9, "standard_charge_percentage": 50.0000, "estimated_amount": 17209, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 30977.8, "standard_charge_percentage": 90.0000, "estimated_amount": 30977, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 30977.8, "standard_charge_percentage": 90.0000, "estimated_amount": 30977, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 29256.8, "standard_charge_percentage": 85.0000, "estimated_amount": 29256, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 27535.8, "standard_charge_percentage": 80.0000, "estimated_amount": 27535, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 27535.8, "standard_charge_percentage": 80.0000, "estimated_amount": 27535, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 24093.9, "standard_charge_percentage": 70.0000, "estimated_amount": 24093, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 24093.9, "standard_charge_percentage": 70.0000, "estimated_amount": 24093, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 28224.2, "standard_charge_percentage": 82.0000, "estimated_amount": 28224, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 19963.5, "standard_charge_percentage": 58.0000, "estimated_amount": 19963, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 25814.8, "standard_charge_percentage": 75.0000, "estimated_amount": 25814, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 20651.9, "standard_charge_percentage": 60.0000, "estimated_amount": 20651, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 11494.8, "estimated_amount": 11494, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5440, "estimated_amount": 5440, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 13767.9, "standard_charge_percentage": 40.0000, "estimated_amount": 13767, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 32698.8, "standard_charge_percentage": 95.0000, "estimated_amount": 32698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 27535.8, "standard_charge_percentage": 80.0000, "estimated_amount": 27535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 25814.8, "standard_charge_percentage": 75.0000, "estimated_amount": 25814, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 19275.1, "standard_charge_percentage": 56.0000, "estimated_amount": 19275, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 30977.8, "standard_charge_percentage": 90.0000, "estimated_amount": 30977, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 25814.8, "standard_charge_percentage": 75.0000, "estimated_amount": 25814, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 30977.8, "standard_charge_percentage": 90.0000, "estimated_amount": 30977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 30117.3, "standard_charge_percentage": 87.5000, "estimated_amount": 30117, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 27535.8, "standard_charge_percentage": 80.0000, "estimated_amount": 27535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 34419.8, "standard_charge_percentage": 100.0000, "estimated_amount": 34419, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 20651.9, "standard_charge_percentage": 60.0000, "estimated_amount": 20651, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 27535.8, "standard_charge_percentage": 80.0000, "estimated_amount": 27535, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 24093.9, "standard_charge_percentage": 70.0000, "estimated_amount": 24093, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 25814.8, "standard_charge_percentage": 75.0000, "estimated_amount": 25814, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Knee Disloc Wo Anes", "code_information": [ { "code": "27550", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1157.15, "discounted_cash": 293,"minimum": 204.5,"maximum": 1157.15,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 925.72, "standard_charge_percentage": 80.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1099.29, "standard_charge_percentage": 95.0000, "estimated_amount": 1099, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1157.15, "standard_charge_percentage": 100.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 347.14, "standard_charge_percentage": 30.0000, "estimated_amount": 347, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 810, "standard_charge_percentage": 70.0000, "estimated_amount": 810, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 867.86, "standard_charge_percentage": 75.0000, "estimated_amount": 867, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 671.15, "standard_charge_percentage": 58.0000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1041.44, "standard_charge_percentage": 90.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 694.29, "standard_charge_percentage": 60.0000, "estimated_amount": 694, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 364, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 867.86, "standard_charge_percentage": 75.0000, "estimated_amount": 867, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 867.86, "standard_charge_percentage": 75.0000, "estimated_amount": 867, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 925.72, "standard_charge_percentage": 80.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 983.58, "standard_charge_percentage": 85.0000, "estimated_amount": 983, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 462.86, "standard_charge_percentage": 40.0000, "estimated_amount": 462, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 694.29, "standard_charge_percentage": 60.0000, "estimated_amount": 694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 925.72, "standard_charge_percentage": 80.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 925.72, "standard_charge_percentage": 80.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 925.72, "standard_charge_percentage": 80.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 810, "standard_charge_percentage": 70.0000, "estimated_amount": 810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1157.15, "estimated_amount": 1157, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 925.72, "standard_charge_percentage": 80.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 925.72, "standard_charge_percentage": 80.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1157.15, "standard_charge_percentage": 100.0000, "estimated_amount": 1157, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 925.72, "standard_charge_percentage": 80.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 867.86, "standard_charge_percentage": 75.0000, "estimated_amount": 867, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 648, "standard_charge_percentage": 56.0000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 428.15, "standard_charge_percentage": 37.0000, "estimated_amount": 428, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 925.72, "standard_charge_percentage": 80.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1041.44, "standard_charge_percentage": 90.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1134.01, "standard_charge_percentage": 98.0000, "estimated_amount": 1134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 578.58, "standard_charge_percentage": 50.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1041.44, "standard_charge_percentage": 90.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1041.44, "standard_charge_percentage": 90.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1041.44, "standard_charge_percentage": 90.0000, "estimated_amount": 1041, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1012.51, "standard_charge_percentage": 87.5000, "estimated_amount": 1012, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1012.51, "standard_charge_percentage": 87.5000, "estimated_amount": 1012, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 925.72, "standard_charge_percentage": 80.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 810, "standard_charge_percentage": 70.0000, "estimated_amount": 810, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 948.86, "standard_charge_percentage": 82.0000, "estimated_amount": 948, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 867.86, "standard_charge_percentage": 75.0000, "estimated_amount": 867, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Patellr Disloc Wo Anes", "code_information": [ { "code": "27560", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 364, "estimated_amount": 364, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" }]}]} , { "description": "Repair of achilles tendon", "code_information": [ { "code": "27654", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 23565.7, "discounted_cash": 8736,"minimum": 1123,"maximum": 23565.7,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 23565.7, "standard_charge_percentage": 100.0000, "estimated_amount": 23565, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 14139.4, "standard_charge_percentage": 60.0000, "estimated_amount": 14139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 7069.71, "standard_charge_percentage": 30.0000, "estimated_amount": 7069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 17674.3, "standard_charge_percentage": 75.0000, "estimated_amount": 17674, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 16496, "standard_charge_percentage": 70.0000, "estimated_amount": 16495, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 13668.1, "standard_charge_percentage": 58.0000, "estimated_amount": 13668, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 21209.1, "standard_charge_percentage": 90.0000, "estimated_amount": 21209, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 17674.3, "standard_charge_percentage": 75.0000, "estimated_amount": 17674, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 18852.6, "standard_charge_percentage": 80.0000, "estimated_amount": 18852, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 17674.3, "standard_charge_percentage": 75.0000, "estimated_amount": 17674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 18852.6, "standard_charge_percentage": 80.0000, "estimated_amount": 18852, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 11782.9, "standard_charge_percentage": 50.0000, "estimated_amount": 11782, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 9426.28, "standard_charge_percentage": 40.0000, "estimated_amount": 9426, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 20620, "standard_charge_percentage": 87.5000, "estimated_amount": 20619, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 23565.7, "standard_charge_percentage": 100.0000, "estimated_amount": 23565, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 18852.6, "standard_charge_percentage": 80.0000, "estimated_amount": 18852, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 18852.6, "standard_charge_percentage": 80.0000, "estimated_amount": 18852, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 19323.9, "standard_charge_percentage": 82.0000, "estimated_amount": 19323, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 23565.7, "estimated_amount": 23565, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 21209.1, "standard_charge_percentage": 90.0000, "estimated_amount": 21209, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 20030.8, "standard_charge_percentage": 85.0000, "estimated_amount": 20030, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 20620, "standard_charge_percentage": 87.5000, "estimated_amount": 20619, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 18852.6, "standard_charge_percentage": 80.0000, "estimated_amount": 18852, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 13196.8, "standard_charge_percentage": 56.0000, "estimated_amount": 13196, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 21209.1, "standard_charge_percentage": 90.0000, "estimated_amount": 21209, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 23094.4, "standard_charge_percentage": 98.0000, "estimated_amount": 23094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 14139.4, "standard_charge_percentage": 60.0000, "estimated_amount": 14139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 21209.1, "standard_charge_percentage": 90.0000, "estimated_amount": 21209, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 21209.1, "standard_charge_percentage": 90.0000, "estimated_amount": 21209, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 18852.6, "standard_charge_percentage": 80.0000, "estimated_amount": 18852, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 18852.6, "standard_charge_percentage": 80.0000, "estimated_amount": 18852, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 22387.4, "standard_charge_percentage": 95.0000, "estimated_amount": 22387, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 18852.6, "standard_charge_percentage": 80.0000, "estimated_amount": 18852, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 18852.6, "standard_charge_percentage": 80.0000, "estimated_amount": 18852, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 16496, "standard_charge_percentage": 70.0000, "estimated_amount": 16495, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 16496, "standard_charge_percentage": 70.0000, "estimated_amount": 16495, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 17674.3, "standard_charge_percentage": 75.0000, "estimated_amount": 17674, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 18852.6, "standard_charge_percentage": 80.0000, "estimated_amount": 18852, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 17674.3, "standard_charge_percentage": 75.0000, "estimated_amount": 17674, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13440.5, "estimated_amount": 13440, "methodology": "fee schedule" }]}]} , { "description": "Hc Manipulation Of Hip Joint", "code_information": [ { "code": "27725", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7302.3,"minimum": 2190.69,"maximum": 7302.3,"payers_information":[{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5841.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5841, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 6937.19, "standard_charge_percentage": 95.0000, "estimated_amount": 6937, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5841.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5841, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5476.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5476, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4489, "estimated_amount": 4489, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5841.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5841, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6572.07, "standard_charge_percentage": 90.0000, "estimated_amount": 6572, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6572.07, "standard_charge_percentage": 90.0000, "estimated_amount": 6572, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6572.07, "standard_charge_percentage": 90.0000, "estimated_amount": 6572, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6389.51, "standard_charge_percentage": 87.5000, "estimated_amount": 6389, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7302.3, "standard_charge_percentage": 100.0000, "estimated_amount": 7302, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7302.3, "standard_charge_percentage": 100.0000, "estimated_amount": 7302, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5841.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5841, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5841.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5841, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5111.61, "standard_charge_percentage": 70.0000, "estimated_amount": 5111, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5111.61, "standard_charge_percentage": 70.0000, "estimated_amount": 5111, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4089.29, "standard_charge_percentage": 56.0000, "estimated_amount": 4089, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5841.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5841, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5476.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5476, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5476.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5476, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5476.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5476, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5841.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5841, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6206.95, "standard_charge_percentage": 85.0000, "estimated_amount": 6206, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2920.92, "standard_charge_percentage": 40.0000, "estimated_amount": 2920, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4381.38, "standard_charge_percentage": 60.0000, "estimated_amount": 4381, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5841.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5476.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5476, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5111.61, "standard_charge_percentage": 70.0000, "estimated_amount": 5111, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4235.33, "standard_charge_percentage": 58.0000, "estimated_amount": 4235, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3651.15, "standard_charge_percentage": 50.0000, "estimated_amount": 3651, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6389.51, "standard_charge_percentage": 87.5000, "estimated_amount": 6389, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5841.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5841, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5841.84, "standard_charge_percentage": 80.0000, "estimated_amount": 5841, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2190.69, "standard_charge_percentage": 30.0000, "estimated_amount": 2190, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 5987.89, "standard_charge_percentage": 82.0000, "estimated_amount": 5987, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2701.85, "standard_charge_percentage": 37.0000, "estimated_amount": 2701, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6572.07, "standard_charge_percentage": 90.0000, "estimated_amount": 6572, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6572.07, "standard_charge_percentage": 90.0000, "estimated_amount": 6572, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7156.25, "standard_charge_percentage": 98.0000, "estimated_amount": 7156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4381.38, "standard_charge_percentage": 60.0000, "estimated_amount": 4381, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Clsd Treat Dist Fibula Fx W Manip", "code_information": [ { "code": "27788", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1199.4, "discounted_cash": 293,"minimum": 204.5,"maximum": 1199.4,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 899.55, "standard_charge_percentage": 75.0000, "estimated_amount": 899, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 899.55, "standard_charge_percentage": 75.0000, "estimated_amount": 899, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1079.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1079, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1019.49, "standard_charge_percentage": 85.0000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 959.52, "standard_charge_percentage": 80.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 959.52, "standard_charge_percentage": 80.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1175.41, "standard_charge_percentage": 98.0000, "estimated_amount": 1175, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 899.55, "standard_charge_percentage": 75.0000, "estimated_amount": 899, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1199.4, "estimated_amount": 1199, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 959.52, "standard_charge_percentage": 80.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1079.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1079, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1049.48, "standard_charge_percentage": 87.5000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 959.52, "standard_charge_percentage": 80.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1199.4, "standard_charge_percentage": 100.0000, "estimated_amount": 1199, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 959.52, "standard_charge_percentage": 80.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 959.52, "standard_charge_percentage": 80.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 959.52, "standard_charge_percentage": 80.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 359.82, "standard_charge_percentage": 30.0000, "estimated_amount": 359, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 839.58, "standard_charge_percentage": 70.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1079.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1049.48, "standard_charge_percentage": 87.5000, "estimated_amount": 1049, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 959.52, "standard_charge_percentage": 80.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1199.4, "standard_charge_percentage": 100.0000, "estimated_amount": 1199, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 719.64, "standard_charge_percentage": 60.0000, "estimated_amount": 719, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 839.58, "standard_charge_percentage": 70.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 839.58, "standard_charge_percentage": 70.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1079.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 959.52, "standard_charge_percentage": 80.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 599.7, "standard_charge_percentage": 50.0000, "estimated_amount": 599, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1079.46, "standard_charge_percentage": 90.0000, "estimated_amount": 1079, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 479.76, "standard_charge_percentage": 40.0000, "estimated_amount": 479, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1139.43, "standard_charge_percentage": 95.0000, "estimated_amount": 1139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 959.52, "standard_charge_percentage": 80.0000, "estimated_amount": 959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 899.55, "standard_charge_percentage": 75.0000, "estimated_amount": 899, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 899.55, "standard_charge_percentage": 75.0000, "estimated_amount": 899, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 983.51, "standard_charge_percentage": 82.0000, "estimated_amount": 983, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 671.66, "standard_charge_percentage": 56.0000, "estimated_amount": 671, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 695.65, "standard_charge_percentage": 58.0000, "estimated_amount": 695, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 443.78, "standard_charge_percentage": 37.0000, "estimated_amount": 443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 719.64, "standard_charge_percentage": 60.0000, "estimated_amount": 719, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" }]}]} , { "description": "Treatment of ankle fracture", "code_information": [ { "code": "27792", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 13847.5, "discounted_cash": 8736,"minimum": 1123,"maximum": 13847.5,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 12462.8, "standard_charge_percentage": 90.0000, "estimated_amount": 12462, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 11078, "standard_charge_percentage": 80.0000, "estimated_amount": 11078, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 13155.1, "standard_charge_percentage": 95.0000, "estimated_amount": 13155, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 9693.25, "standard_charge_percentage": 70.0000, "estimated_amount": 9693, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 12462.8, "standard_charge_percentage": 90.0000, "estimated_amount": 12462, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 10385.6, "standard_charge_percentage": 75.0000, "estimated_amount": 10385, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 10385.6, "standard_charge_percentage": 75.0000, "estimated_amount": 10385, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6923.75, "standard_charge_percentage": 50.0000, "estimated_amount": 6923, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 13847.5, "standard_charge_percentage": 100.0000, "estimated_amount": 13847, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 13847.5, "standard_charge_percentage": 100.0000, "estimated_amount": 13847, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 11078, "standard_charge_percentage": 80.0000, "estimated_amount": 11078, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 11078, "standard_charge_percentage": 80.0000, "estimated_amount": 11078, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 11078, "standard_charge_percentage": 80.0000, "estimated_amount": 11078, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 10385.6, "standard_charge_percentage": 75.0000, "estimated_amount": 10385, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 11355, "standard_charge_percentage": 82.0000, "estimated_amount": 11354, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 7754.6, "standard_charge_percentage": 56.0000, "estimated_amount": 7754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 8308.5, "standard_charge_percentage": 60.0000, "estimated_amount": 8308, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13440.5, "estimated_amount": 13440, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 11078, "standard_charge_percentage": 80.0000, "estimated_amount": 11078, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 12462.8, "standard_charge_percentage": 90.0000, "estimated_amount": 12462, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 12462.8, "standard_charge_percentage": 90.0000, "estimated_amount": 12462, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 12116.6, "standard_charge_percentage": 87.5000, "estimated_amount": 12116, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 11078, "standard_charge_percentage": 80.0000, "estimated_amount": 11078, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 8308.5, "standard_charge_percentage": 60.0000, "estimated_amount": 8308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4154.25, "standard_charge_percentage": 30.0000, "estimated_amount": 4154, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 9693.25, "standard_charge_percentage": 70.0000, "estimated_amount": 9693, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 8031.55, "standard_charge_percentage": 58.0000, "estimated_amount": 8031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 11078, "standard_charge_percentage": 80.0000, "estimated_amount": 11078, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 12462.8, "standard_charge_percentage": 90.0000, "estimated_amount": 12462, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 13847.5, "estimated_amount": 13847, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 10385.6, "standard_charge_percentage": 75.0000, "estimated_amount": 10385, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 11078, "standard_charge_percentage": 80.0000, "estimated_amount": 11078, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 11770.4, "standard_charge_percentage": 85.0000, "estimated_amount": 11770, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5539, "standard_charge_percentage": 40.0000, "estimated_amount": 5539, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 12116.6, "standard_charge_percentage": 87.5000, "estimated_amount": 12116, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 11078, "standard_charge_percentage": 80.0000, "estimated_amount": 11078, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 11078, "standard_charge_percentage": 80.0000, "estimated_amount": 11078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 10385.6, "standard_charge_percentage": 75.0000, "estimated_amount": 10385, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 9693.25, "standard_charge_percentage": 70.0000, "estimated_amount": 9693, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 13570.5, "standard_charge_percentage": 98.0000, "estimated_amount": 13570, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" }]}]} , { "description": "Treatment of ankle fracture", "code_information": [ { "code": "27814", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 13115.3, "discounted_cash": 8736,"minimum": 1123,"maximum": 13115.3,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 11803.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11803, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 10492.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10492, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 9180.71, "standard_charge_percentage": 70.0000, "estimated_amount": 9180, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 10754.5, "standard_charge_percentage": 82.0000, "estimated_amount": 10754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 10492.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 7869.18, "standard_charge_percentage": 60.0000, "estimated_amount": 7869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 9836.48, "standard_charge_percentage": 75.0000, "estimated_amount": 9836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 10492.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6557.65, "standard_charge_percentage": 50.0000, "estimated_amount": 6557, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 11803.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11803, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 11148, "standard_charge_percentage": 85.0000, "estimated_amount": 11148, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 11475.9, "standard_charge_percentage": 87.5000, "estimated_amount": 11475, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 10492.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10492, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 13115.3, "standard_charge_percentage": 100.0000, "estimated_amount": 13115, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 9836.48, "standard_charge_percentage": 75.0000, "estimated_amount": 9836, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 7344.57, "standard_charge_percentage": 56.0000, "estimated_amount": 7344, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 7606.87, "standard_charge_percentage": 58.0000, "estimated_amount": 7606, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 11803.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11803, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 9836.48, "standard_charge_percentage": 75.0000, "estimated_amount": 9836, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 10492.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10492, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 9836.48, "standard_charge_percentage": 75.0000, "estimated_amount": 9836, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 11803.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11803, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5246.12, "standard_charge_percentage": 40.0000, "estimated_amount": 5246, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 10492.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10492, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 10492.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10492, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 10492.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3934.59, "standard_charge_percentage": 30.0000, "estimated_amount": 3934, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 9180.71, "standard_charge_percentage": 70.0000, "estimated_amount": 9180, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 9180.71, "standard_charge_percentage": 70.0000, "estimated_amount": 9180, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 13115.3, "estimated_amount": 13115, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13115.3, "estimated_amount": 13115, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 11475.9, "standard_charge_percentage": 87.5000, "estimated_amount": 11475, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 10492.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10492, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 12459.5, "standard_charge_percentage": 95.0000, "estimated_amount": 12459, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 13115.3, "standard_charge_percentage": 100.0000, "estimated_amount": 13115, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 7869.18, "standard_charge_percentage": 60.0000, "estimated_amount": 7869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 10492.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 9836.48, "standard_charge_percentage": 75.0000, "estimated_amount": 9836, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 11803.8, "standard_charge_percentage": 90.0000, "estimated_amount": 11803, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 12853, "standard_charge_percentage": 98.0000, "estimated_amount": 12852, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Trimalleolar Fx W Manip", "code_information": [ { "code": "27818", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7772.08, "discounted_cash": 1957,"minimum": 520.65,"maximum": 7772.08,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1964.62, "estimated_amount": 1964, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7383.48, "standard_charge_percentage": 95.0000, "estimated_amount": 7383, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6373.11, "standard_charge_percentage": 82.0000, "estimated_amount": 6373, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4352.36, "standard_charge_percentage": 56.0000, "estimated_amount": 4352, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4507.81, "standard_charge_percentage": 58.0000, "estimated_amount": 4507, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5330.88, "estimated_amount": 5330, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1978.26, "estimated_amount": 1978, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3108.83, "standard_charge_percentage": 40.0000, "estimated_amount": 3108, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6800.57, "standard_charge_percentage": 87.5000, "estimated_amount": 6800, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7616.64, "standard_charge_percentage": 98.0000, "estimated_amount": 7616, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4663.25, "standard_charge_percentage": 60.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2032.47, "estimated_amount": 2032, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1580.81, "estimated_amount": 1580, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3011.06, "estimated_amount": 3011, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1438.25, "estimated_amount": 1438, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7772.08, "standard_charge_percentage": 100.0000, "estimated_amount": 7772, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2331.62, "standard_charge_percentage": 30.0000, "estimated_amount": 2331, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5440.46, "standard_charge_percentage": 70.0000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1535.64, "estimated_amount": 1535, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2408.85, "estimated_amount": 2408, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1364.32, "estimated_amount": 1364, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 520.65, "estimated_amount": 520, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1950.98, "estimated_amount": 1950, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3886.04, "standard_charge_percentage": 50.0000, "estimated_amount": 3886, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6994.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6994, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6606.27, "standard_charge_percentage": 85.0000, "estimated_amount": 6606, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6800.57, "standard_charge_percentage": 87.5000, "estimated_amount": 6800, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7772.08, "standard_charge_percentage": 100.0000, "estimated_amount": 7772, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4663.25, "standard_charge_percentage": 60.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6217.66, "standard_charge_percentage": 80.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2875.67, "standard_charge_percentage": 37.0000, "estimated_amount": 2875, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5829.06, "standard_charge_percentage": 75.0000, "estimated_amount": 5829, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2107.74, "estimated_amount": 2107, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1505.53, "estimated_amount": 1505, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2785.23, "estimated_amount": 2785, "methodology": "fee schedule" }]}]} , { "description": "Treatment of ankle fracture", "code_information": [ { "code": "27822", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 17599.3, "discounted_cash": 8736,"minimum": 1123,"maximum": 17599.3,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 13199.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13199, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 15839.4, "standard_charge_percentage": 90.0000, "estimated_amount": 15839, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 17599.3, "standard_charge_percentage": 100.0000, "estimated_amount": 17599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14079.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14079, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 14079.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14079, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 12319.5, "standard_charge_percentage": 70.0000, "estimated_amount": 12319, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 10207.6, "standard_charge_percentage": 58.0000, "estimated_amount": 10207, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 15839.4, "standard_charge_percentage": 90.0000, "estimated_amount": 15839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13440.5, "estimated_amount": 13440, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 15839.4, "standard_charge_percentage": 90.0000, "estimated_amount": 15839, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 14079.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14079, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 14079.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14079, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 16719.3, "standard_charge_percentage": 95.0000, "estimated_amount": 16719, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 14079.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14079, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 14079.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 13199.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13199, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 12319.5, "standard_charge_percentage": 70.0000, "estimated_amount": 12319, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 13199.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13199, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 17599.3, "estimated_amount": 17599, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 14079.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14079.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14079, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 15839.4, "standard_charge_percentage": 90.0000, "estimated_amount": 15839, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 14959.4, "standard_charge_percentage": 85.0000, "estimated_amount": 14959, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7039.72, "standard_charge_percentage": 40.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 15399.4, "standard_charge_percentage": 87.5000, "estimated_amount": 15399, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 15399.4, "standard_charge_percentage": 87.5000, "estimated_amount": 15399, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5279.79, "standard_charge_percentage": 30.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 14431.4, "standard_charge_percentage": 82.0000, "estimated_amount": 14431, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 9855.61, "standard_charge_percentage": 56.0000, "estimated_amount": 9855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14079.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14079, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 15839.4, "standard_charge_percentage": 90.0000, "estimated_amount": 15839, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 17247.3, "standard_charge_percentage": 98.0000, "estimated_amount": 17247, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 13199.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13199, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 13199.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 8799.65, "standard_charge_percentage": 50.0000, "estimated_amount": 8799, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 14079.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14079, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 17599.3, "standard_charge_percentage": 100.0000, "estimated_amount": 17599, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 10559.6, "standard_charge_percentage": 60.0000, "estimated_amount": 10559, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 12319.5, "standard_charge_percentage": 70.0000, "estimated_amount": 12319, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 10559.6, "standard_charge_percentage": 60.0000, "estimated_amount": 10559, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Ankle Disloc Wo Anes", "code_information": [ { "code": "27840", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1116.6, "discounted_cash": 293,"minimum": 204.5,"maximum": 1116.6,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 893.28, "standard_charge_percentage": 80.0000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1004.94, "standard_charge_percentage": 90.0000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 446.64, "standard_charge_percentage": 40.0000, "estimated_amount": 446, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 977.02, "standard_charge_percentage": 87.5000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 893.28, "standard_charge_percentage": 80.0000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 781.62, "standard_charge_percentage": 70.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 915.61, "standard_charge_percentage": 82.0000, "estimated_amount": 915, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 625.3, "standard_charge_percentage": 56.0000, "estimated_amount": 625, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 647.63, "standard_charge_percentage": 58.0000, "estimated_amount": 647, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 893.28, "standard_charge_percentage": 80.0000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 669.96, "standard_charge_percentage": 60.0000, "estimated_amount": 669, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1116.6, "estimated_amount": 1116, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 837.45, "standard_charge_percentage": 75.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 893.28, "standard_charge_percentage": 80.0000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1004.94, "standard_charge_percentage": 90.0000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1004.94, "standard_charge_percentage": 90.0000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 949.11, "standard_charge_percentage": 85.0000, "estimated_amount": 949, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 977.02, "standard_charge_percentage": 87.5000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 893.28, "standard_charge_percentage": 80.0000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 893.28, "standard_charge_percentage": 80.0000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 334.98, "standard_charge_percentage": 30.0000, "estimated_amount": 334, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 837.45, "standard_charge_percentage": 75.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 781.62, "standard_charge_percentage": 70.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 781.62, "standard_charge_percentage": 70.0000, "estimated_amount": 781, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1004.94, "standard_charge_percentage": 90.0000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 837.45, "standard_charge_percentage": 75.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 558.3, "standard_charge_percentage": 50.0000, "estimated_amount": 558, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 893.28, "standard_charge_percentage": 80.0000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1060.77, "standard_charge_percentage": 95.0000, "estimated_amount": 1060, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1116.6, "standard_charge_percentage": 100.0000, "estimated_amount": 1116, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 893.28, "standard_charge_percentage": 80.0000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 893.28, "standard_charge_percentage": 80.0000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 837.45, "standard_charge_percentage": 75.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1116.6, "standard_charge_percentage": 100.0000, "estimated_amount": 1116, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 669.96, "standard_charge_percentage": 60.0000, "estimated_amount": 669, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 893.28, "standard_charge_percentage": 80.0000, "estimated_amount": 893, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 413.14, "standard_charge_percentage": 37.0000, "estimated_amount": 413, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1004.94, "standard_charge_percentage": 90.0000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1094.27, "standard_charge_percentage": 98.0000, "estimated_amount": 1094, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 837.45, "standard_charge_percentage": 75.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "28060", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4443.55, "discounted_cash": 3967,"minimum": 898,"maximum": 4443.55,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3999.2, "standard_charge_percentage": 90.0000, "estimated_amount": 3999, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3777.02, "standard_charge_percentage": 85.0000, "estimated_amount": 3777, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3554.84, "standard_charge_percentage": 80.0000, "estimated_amount": 3554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 4221.37, "standard_charge_percentage": 95.0000, "estimated_amount": 4221, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3554.84, "standard_charge_percentage": 80.0000, "estimated_amount": 3554, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3554.84, "standard_charge_percentage": 80.0000, "estimated_amount": 3554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1333.07, "standard_charge_percentage": 30.0000, "estimated_amount": 1333, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3110.49, "standard_charge_percentage": 70.0000, "estimated_amount": 3110, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3643.71, "standard_charge_percentage": 82.0000, "estimated_amount": 3643, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3999.2, "standard_charge_percentage": 90.0000, "estimated_amount": 3999, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3999.2, "standard_charge_percentage": 90.0000, "estimated_amount": 3999, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 4443.55, "estimated_amount": 4443, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4443.55, "estimated_amount": 4443, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3554.84, "standard_charge_percentage": 80.0000, "estimated_amount": 3554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3554.84, "standard_charge_percentage": 80.0000, "estimated_amount": 3554, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3999.2, "standard_charge_percentage": 90.0000, "estimated_amount": 3999, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3554.84, "standard_charge_percentage": 80.0000, "estimated_amount": 3554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 4443.55, "standard_charge_percentage": 100.0000, "estimated_amount": 4443, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2666.13, "standard_charge_percentage": 60.0000, "estimated_amount": 2666, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3554.84, "standard_charge_percentage": 80.0000, "estimated_amount": 3554, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3554.84, "standard_charge_percentage": 80.0000, "estimated_amount": 3554, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 4354.68, "standard_charge_percentage": 98.0000, "estimated_amount": 4354, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3332.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3332, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2666.13, "standard_charge_percentage": 60.0000, "estimated_amount": 2666, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4443.55, "estimated_amount": 4443, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 4443.55, "estimated_amount": 4443, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3999.2, "standard_charge_percentage": 90.0000, "estimated_amount": 3999, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3888.11, "standard_charge_percentage": 87.5000, "estimated_amount": 3888, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 4443.55, "standard_charge_percentage": 100.0000, "estimated_amount": 4443, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3110.49, "standard_charge_percentage": 70.0000, "estimated_amount": 3110, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2488.39, "standard_charge_percentage": 56.0000, "estimated_amount": 2488, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3332.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3332, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3332.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3332, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2221.78, "standard_charge_percentage": 50.0000, "estimated_amount": 2221, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1777.42, "standard_charge_percentage": 40.0000, "estimated_amount": 1777, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3888.11, "standard_charge_percentage": 87.5000, "estimated_amount": 3888, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3554.84, "standard_charge_percentage": 80.0000, "estimated_amount": 3554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3332.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3332, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3110.49, "standard_charge_percentage": 70.0000, "estimated_amount": 3110, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3332.66, "standard_charge_percentage": 75.0000, "estimated_amount": 3332, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2577.26, "standard_charge_percentage": 58.0000, "estimated_amount": 2577, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3554.84, "standard_charge_percentage": 80.0000, "estimated_amount": 3554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4443.55, "estimated_amount": 4443, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "28110", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 12251.4, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 12251.4,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 9801.11, "standard_charge_percentage": 80.0000, "estimated_amount": 9801, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 11026.3, "standard_charge_percentage": 90.0000, "estimated_amount": 11026, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 11026.3, "standard_charge_percentage": 90.0000, "estimated_amount": 11026, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 4900.56, "standard_charge_percentage": 40.0000, "estimated_amount": 4900, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 10720, "standard_charge_percentage": 87.5000, "estimated_amount": 10719, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 12251.4, "standard_charge_percentage": 100.0000, "estimated_amount": 12251, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 9801.11, "standard_charge_percentage": 80.0000, "estimated_amount": 9801, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 8575.97, "standard_charge_percentage": 70.0000, "estimated_amount": 8575, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 10046.1, "standard_charge_percentage": 82.0000, "estimated_amount": 10046, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 7105.81, "standard_charge_percentage": 58.0000, "estimated_amount": 7105, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 11026.3, "standard_charge_percentage": 90.0000, "estimated_amount": 11026, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 12006.4, "standard_charge_percentage": 98.0000, "estimated_amount": 12006, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 7350.83, "standard_charge_percentage": 60.0000, "estimated_amount": 7350, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 9188.54, "standard_charge_percentage": 75.0000, "estimated_amount": 9188, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 9188.54, "standard_charge_percentage": 75.0000, "estimated_amount": 9188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 9801.11, "standard_charge_percentage": 80.0000, "estimated_amount": 9801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6125.69, "standard_charge_percentage": 50.0000, "estimated_amount": 6125, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 10720, "standard_charge_percentage": 87.5000, "estimated_amount": 10719, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 9801.11, "standard_charge_percentage": 80.0000, "estimated_amount": 9801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 11638.8, "standard_charge_percentage": 95.0000, "estimated_amount": 11638, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 7350.83, "standard_charge_percentage": 60.0000, "estimated_amount": 7350, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 9801.11, "standard_charge_percentage": 80.0000, "estimated_amount": 9801, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 9188.54, "standard_charge_percentage": 75.0000, "estimated_amount": 9188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 9801.11, "standard_charge_percentage": 80.0000, "estimated_amount": 9801, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 11026.3, "standard_charge_percentage": 90.0000, "estimated_amount": 11026, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 11026.3, "standard_charge_percentage": 90.0000, "estimated_amount": 11026, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 10413.7, "standard_charge_percentage": 85.0000, "estimated_amount": 10413, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 9801.11, "standard_charge_percentage": 80.0000, "estimated_amount": 9801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 9801.11, "standard_charge_percentage": 80.0000, "estimated_amount": 9801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 9801.11, "standard_charge_percentage": 80.0000, "estimated_amount": 9801, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 9801.11, "standard_charge_percentage": 80.0000, "estimated_amount": 9801, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 8575.97, "standard_charge_percentage": 70.0000, "estimated_amount": 8575, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 6860.78, "standard_charge_percentage": 56.0000, "estimated_amount": 6860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 12251.4, "standard_charge_percentage": 100.0000, "estimated_amount": 12251, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3675.42, "standard_charge_percentage": 30.0000, "estimated_amount": 3675, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 8575.97, "standard_charge_percentage": 70.0000, "estimated_amount": 8575, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 9188.54, "standard_charge_percentage": 75.0000, "estimated_amount": 9188, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 9188.54, "standard_charge_percentage": 75.0000, "estimated_amount": 9188, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 10807.7, "estimated_amount": 10807, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" }]}]} , { "description": "Partial removal of foot bone", "code_information": [ { "code": "28122", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7371.71, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 7371.71,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6265.95, "standard_charge_percentage": 85.0000, "estimated_amount": 6265, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7371.71, "standard_charge_percentage": 100.0000, "estimated_amount": 7371, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7003.12, "standard_charge_percentage": 95.0000, "estimated_amount": 7003, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4423.03, "standard_charge_percentage": 60.0000, "estimated_amount": 4423, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6044.8, "standard_charge_percentage": 82.0000, "estimated_amount": 6044, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4275.59, "standard_charge_percentage": 58.0000, "estimated_amount": 4275, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6450.25, "standard_charge_percentage": 87.5000, "estimated_amount": 6450, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7371.71, "standard_charge_percentage": 100.0000, "estimated_amount": 7371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5160.2, "standard_charge_percentage": 70.0000, "estimated_amount": 5160, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5160.2, "standard_charge_percentage": 70.0000, "estimated_amount": 5160, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 7371.71, "estimated_amount": 7371, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5528.78, "standard_charge_percentage": 75.0000, "estimated_amount": 5528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3685.86, "standard_charge_percentage": 50.0000, "estimated_amount": 3685, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2948.68, "standard_charge_percentage": 40.0000, "estimated_amount": 2948, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6450.25, "standard_charge_percentage": 87.5000, "estimated_amount": 6450, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5897.37, "standard_charge_percentage": 80.0000, "estimated_amount": 5897, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2211.51, "standard_charge_percentage": 30.0000, "estimated_amount": 2211, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5160.2, "standard_charge_percentage": 70.0000, "estimated_amount": 5160, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4128.16, "standard_charge_percentage": 56.0000, "estimated_amount": 4128, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6634.54, "standard_charge_percentage": 90.0000, "estimated_amount": 6634, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7224.28, "standard_charge_percentage": 98.0000, "estimated_amount": 7224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4423.03, "standard_charge_percentage": 60.0000, "estimated_amount": 4423, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "28124", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8212.78, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 8212.78,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7391.5, "standard_charge_percentage": 90.0000, "estimated_amount": 7391, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7391.5, "standard_charge_percentage": 90.0000, "estimated_amount": 7391, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7186.18, "standard_charge_percentage": 87.5000, "estimated_amount": 7186, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6570.22, "standard_charge_percentage": 80.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8212.78, "standard_charge_percentage": 100.0000, "estimated_amount": 8212, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6570.22, "standard_charge_percentage": 80.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6570.22, "standard_charge_percentage": 80.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6159.59, "standard_charge_percentage": 75.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5748.95, "standard_charge_percentage": 70.0000, "estimated_amount": 5748, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4763.41, "standard_charge_percentage": 58.0000, "estimated_amount": 4763, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3038.73, "standard_charge_percentage": 37.0000, "estimated_amount": 3038, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 8212.78, "estimated_amount": 8212, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6159.59, "standard_charge_percentage": 75.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6570.22, "standard_charge_percentage": 80.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4106.39, "standard_charge_percentage": 50.0000, "estimated_amount": 4106, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7391.5, "standard_charge_percentage": 90.0000, "estimated_amount": 7391, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 40.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7186.18, "standard_charge_percentage": 87.5000, "estimated_amount": 7186, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6570.22, "standard_charge_percentage": 80.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7802.14, "standard_charge_percentage": 95.0000, "estimated_amount": 7802, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6570.22, "standard_charge_percentage": 80.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2463.83, "standard_charge_percentage": 30.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5748.95, "standard_charge_percentage": 70.0000, "estimated_amount": 5748, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6734.48, "standard_charge_percentage": 82.0000, "estimated_amount": 6734, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4599.16, "standard_charge_percentage": 56.0000, "estimated_amount": 4599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6570.22, "standard_charge_percentage": 80.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7391.5, "standard_charge_percentage": 90.0000, "estimated_amount": 7391, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6570.22, "standard_charge_percentage": 80.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6159.59, "standard_charge_percentage": 75.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8212.78, "standard_charge_percentage": 100.0000, "estimated_amount": 8212, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6570.22, "standard_charge_percentage": 80.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8048.52, "standard_charge_percentage": 98.0000, "estimated_amount": 8048, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6159.59, "standard_charge_percentage": 75.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4927.67, "standard_charge_percentage": 60.0000, "estimated_amount": 4927, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6980.86, "standard_charge_percentage": 85.0000, "estimated_amount": 6980, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6570.22, "standard_charge_percentage": 80.0000, "estimated_amount": 6570, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4927.67, "standard_charge_percentage": 60.0000, "estimated_amount": 4927, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5748.95, "standard_charge_percentage": 70.0000, "estimated_amount": 5748, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6159.59, "standard_charge_percentage": 75.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7391.5, "standard_charge_percentage": 90.0000, "estimated_amount": 7391, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "28192", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2933.03, "discounted_cash": 1981,"minimum": 525.22,"maximum": 2933.03,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2199.77, "standard_charge_percentage": 75.0000, "estimated_amount": 2199, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2493.08, "standard_charge_percentage": 85.0000, "estimated_amount": 2493, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1173.21, "standard_charge_percentage": 40.0000, "estimated_amount": 1173, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2566.4, "standard_charge_percentage": 87.5000, "estimated_amount": 2566, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1759.82, "standard_charge_percentage": 60.0000, "estimated_amount": 1759, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2346.42, "standard_charge_percentage": 80.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2933.03, "estimated_amount": 2933, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2199.77, "standard_charge_percentage": 75.0000, "estimated_amount": 2199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2346.42, "standard_charge_percentage": 80.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2639.73, "standard_charge_percentage": 90.0000, "estimated_amount": 2639, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2639.73, "standard_charge_percentage": 90.0000, "estimated_amount": 2639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2933.03, "standard_charge_percentage": 100.0000, "estimated_amount": 2933, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2346.42, "standard_charge_percentage": 80.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2053.12, "standard_charge_percentage": 70.0000, "estimated_amount": 2053, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2053.12, "standard_charge_percentage": 70.0000, "estimated_amount": 2053, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2199.77, "standard_charge_percentage": 75.0000, "estimated_amount": 2199, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2346.42, "standard_charge_percentage": 80.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2639.73, "standard_charge_percentage": 90.0000, "estimated_amount": 2639, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1759.82, "standard_charge_percentage": 60.0000, "estimated_amount": 1759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2933.03, "estimated_amount": 2933, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2346.42, "standard_charge_percentage": 80.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1466.52, "standard_charge_percentage": 50.0000, "estimated_amount": 1466, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2639.73, "standard_charge_percentage": 90.0000, "estimated_amount": 2639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2566.4, "standard_charge_percentage": 87.5000, "estimated_amount": 2566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2786.38, "standard_charge_percentage": 95.0000, "estimated_amount": 2786, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2933.03, "standard_charge_percentage": 100.0000, "estimated_amount": 2933, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2405.08, "standard_charge_percentage": 82.0000, "estimated_amount": 2405, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1642.5, "standard_charge_percentage": 56.0000, "estimated_amount": 1642, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2874.37, "standard_charge_percentage": 98.0000, "estimated_amount": 2874, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2346.42, "standard_charge_percentage": 80.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2346.42, "standard_charge_percentage": 80.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2346.42, "standard_charge_percentage": 80.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2346.42, "standard_charge_percentage": 80.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2346.42, "standard_charge_percentage": 80.0000, "estimated_amount": 2346, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 879.91, "standard_charge_percentage": 30.0000, "estimated_amount": 879, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2199.77, "standard_charge_percentage": 75.0000, "estimated_amount": 2199, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2053.12, "standard_charge_percentage": 70.0000, "estimated_amount": 2053, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1701.16, "standard_charge_percentage": 58.0000, "estimated_amount": 1701, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2639.73, "standard_charge_percentage": 90.0000, "estimated_amount": 2639, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2199.77, "standard_charge_percentage": 75.0000, "estimated_amount": 2199, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "Repair of hammertoe", "code_information": [ { "code": "28285", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 10875.9, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 10875.9,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 8156.93, "standard_charge_percentage": 75.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 5437.95, "standard_charge_percentage": 50.0000, "estimated_amount": 5437, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 9244.51, "standard_charge_percentage": 85.0000, "estimated_amount": 9244, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 9516.41, "standard_charge_percentage": 87.5000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 10875.9, "standard_charge_percentage": 100.0000, "estimated_amount": 10875, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 10875.9, "standard_charge_percentage": 100.0000, "estimated_amount": 10875, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 7613.13, "standard_charge_percentage": 70.0000, "estimated_amount": 7613, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 7613.13, "standard_charge_percentage": 70.0000, "estimated_amount": 7613, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 8156.93, "standard_charge_percentage": 75.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 8700.72, "standard_charge_percentage": 80.0000, "estimated_amount": 8700, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 9788.31, "standard_charge_percentage": 90.0000, "estimated_amount": 9788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 8700.72, "standard_charge_percentage": 80.0000, "estimated_amount": 8700, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 9788.31, "standard_charge_percentage": 90.0000, "estimated_amount": 9788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 8700.72, "standard_charge_percentage": 80.0000, "estimated_amount": 8700, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 6525.54, "standard_charge_percentage": 60.0000, "estimated_amount": 6525, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 8700.72, "standard_charge_percentage": 80.0000, "estimated_amount": 8700, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 8700.72, "standard_charge_percentage": 80.0000, "estimated_amount": 8700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 8156.93, "standard_charge_percentage": 75.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 8156.93, "standard_charge_percentage": 75.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 9788.31, "standard_charge_percentage": 90.0000, "estimated_amount": 9788, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 9788.31, "standard_charge_percentage": 90.0000, "estimated_amount": 9788, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 4350.36, "standard_charge_percentage": 40.0000, "estimated_amount": 4350, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 9516.41, "standard_charge_percentage": 87.5000, "estimated_amount": 9516, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 8700.72, "standard_charge_percentage": 80.0000, "estimated_amount": 8700, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 6090.5, "standard_charge_percentage": 56.0000, "estimated_amount": 6090, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 9788.31, "standard_charge_percentage": 90.0000, "estimated_amount": 9788, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 10807.7, "estimated_amount": 10807, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 8700.72, "standard_charge_percentage": 80.0000, "estimated_amount": 8700, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 8700.72, "standard_charge_percentage": 80.0000, "estimated_amount": 8700, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 10332.1, "standard_charge_percentage": 95.0000, "estimated_amount": 10332, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 8700.72, "standard_charge_percentage": 80.0000, "estimated_amount": 8700, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 8700.72, "standard_charge_percentage": 80.0000, "estimated_amount": 8700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3262.77, "standard_charge_percentage": 30.0000, "estimated_amount": 3262, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 7613.13, "standard_charge_percentage": 70.0000, "estimated_amount": 7613, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 8918.24, "standard_charge_percentage": 82.0000, "estimated_amount": 8918, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 6308.02, "standard_charge_percentage": 58.0000, "estimated_amount": 6308, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 10658.4, "standard_charge_percentage": 98.0000, "estimated_amount": 10658, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 8156.93, "standard_charge_percentage": 75.0000, "estimated_amount": 8156, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 6525.54, "standard_charge_percentage": 60.0000, "estimated_amount": 6525, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "28296", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5906.73, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 5906.73,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4430.05, "standard_charge_percentage": 75.0000, "estimated_amount": 4430, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4725.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2953.36, "standard_charge_percentage": 50.0000, "estimated_amount": 2953, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5316.06, "standard_charge_percentage": 90.0000, "estimated_amount": 5316, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5316.06, "standard_charge_percentage": 90.0000, "estimated_amount": 5316, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5020.72, "standard_charge_percentage": 85.0000, "estimated_amount": 5020, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5168.39, "standard_charge_percentage": 87.5000, "estimated_amount": 5168, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5906.73, "standard_charge_percentage": 100.0000, "estimated_amount": 5906, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3544.04, "standard_charge_percentage": 60.0000, "estimated_amount": 3544, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4725.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4725, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4725.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4725, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4430.05, "standard_charge_percentage": 75.0000, "estimated_amount": 4430, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3425.9, "standard_charge_percentage": 58.0000, "estimated_amount": 3425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5788.6, "standard_charge_percentage": 98.0000, "estimated_amount": 5788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3544.04, "standard_charge_percentage": 60.0000, "estimated_amount": 3544, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2362.69, "standard_charge_percentage": 40.0000, "estimated_amount": 2362, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4725.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4725, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5906.73, "standard_charge_percentage": 100.0000, "estimated_amount": 5906, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4725.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1772.02, "standard_charge_percentage": 30.0000, "estimated_amount": 1772, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4134.71, "standard_charge_percentage": 70.0000, "estimated_amount": 4134, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3307.77, "standard_charge_percentage": 56.0000, "estimated_amount": 3307, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5316.06, "standard_charge_percentage": 90.0000, "estimated_amount": 5316, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4430.05, "standard_charge_percentage": 75.0000, "estimated_amount": 4430, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4725.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4725, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4725.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4725, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4725.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4725, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4134.71, "standard_charge_percentage": 70.0000, "estimated_amount": 4134, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4134.71, "standard_charge_percentage": 70.0000, "estimated_amount": 4134, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4843.52, "standard_charge_percentage": 82.0000, "estimated_amount": 4843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5906.73, "estimated_amount": 5906, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4430.05, "standard_charge_percentage": 75.0000, "estimated_amount": 4430, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5316.06, "standard_charge_percentage": 90.0000, "estimated_amount": 5316, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5168.39, "standard_charge_percentage": 87.5000, "estimated_amount": 5168, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5611.39, "standard_charge_percentage": 95.0000, "estimated_amount": 5611, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4725.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4430.05, "standard_charge_percentage": 75.0000, "estimated_amount": 4430, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4725.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4725, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5316.06, "standard_charge_percentage": 90.0000, "estimated_amount": 5316, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5906.73, "estimated_amount": 5906, "methodology": "fee schedule" }]}]} , { "description": "Cor Hlx Vlgs Jt Arthrd", "code_information": [ { "code": "28297", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 34599.1, "discounted_cash": 15735,"minimum": 1123,"maximum": 34599.1,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 25949.3, "standard_charge_percentage": 75.0000, "estimated_amount": 25949, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 17299.5, "standard_charge_percentage": 50.0000, "estimated_amount": 17299, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 30274.2, "standard_charge_percentage": 87.5000, "estimated_amount": 30274, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 27679.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 27679.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 32869.1, "standard_charge_percentage": 95.0000, "estimated_amount": 32869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10379.7, "standard_charge_percentage": 30.0000, "estimated_amount": 10379, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 24219.4, "standard_charge_percentage": 70.0000, "estimated_amount": 24219, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 20067.5, "standard_charge_percentage": 58.0000, "estimated_amount": 20067, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 20759.5, "standard_charge_percentage": 60.0000, "estimated_amount": 20759, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 16945.7, "estimated_amount": 16945, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 22392.5, "estimated_amount": 22392, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 19366.5, "estimated_amount": 19366, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 15795, "estimated_amount": 15794, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 10968.7, "estimated_amount": 10968, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 15904.6, "estimated_amount": 15904, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 15685.3, "estimated_amount": 15685, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 25949.3, "standard_charge_percentage": 75.0000, "estimated_amount": 25949, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 27679.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 30274.2, "standard_charge_percentage": 87.5000, "estimated_amount": 30274, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 34599.1, "standard_charge_percentage": 100.0000, "estimated_amount": 34599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 27679.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 27679.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 27679.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 33907.1, "standard_charge_percentage": 98.0000, "estimated_amount": 33907, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 25949.3, "standard_charge_percentage": 75.0000, "estimated_amount": 25949, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 16340.5, "estimated_amount": 16340, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 24208.1, "estimated_amount": 24208, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 10968.7, "estimated_amount": 10968, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 27679.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 31139.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31139, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 31139.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31139, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 31139.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31139, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 29409.2, "standard_charge_percentage": 85.0000, "estimated_amount": 29409, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 13839.6, "standard_charge_percentage": 40.0000, "estimated_amount": 13839, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 20759.5, "standard_charge_percentage": 60.0000, "estimated_amount": 20759, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 24219.4, "standard_charge_percentage": 70.0000, "estimated_amount": 24219, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 25949.3, "standard_charge_percentage": 75.0000, "estimated_amount": 25949, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 28371.3, "standard_charge_percentage": 82.0000, "estimated_amount": 28371, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 31139.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 16945.7, "estimated_amount": 16945, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 27679.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 34599.1, "standard_charge_percentage": 100.0000, "estimated_amount": 34599, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 27679.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 25949.3, "standard_charge_percentage": 75.0000, "estimated_amount": 25949, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 24219.4, "standard_charge_percentage": 70.0000, "estimated_amount": 24219, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 19375.5, "standard_charge_percentage": 56.0000, "estimated_amount": 19375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 27679.3, "standard_charge_percentage": 80.0000, "estimated_amount": 27679, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 31139.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31139, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 34599.1, "estimated_amount": 34599, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 12709.3, "estimated_amount": 12709, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 12346.2, "estimated_amount": 12346, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 19366.5, "estimated_amount": 19366, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 12709.3, "estimated_amount": 12709, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 12104.1, "estimated_amount": 12104, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "28299", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2628.48, "discounted_cash": 8736,"minimum": 788.54,"maximum": 2628.48,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1971.36, "standard_charge_percentage": 75.0000, "estimated_amount": 1971, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2299.92, "standard_charge_percentage": 87.5000, "estimated_amount": 2299, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2102.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2628.48, "standard_charge_percentage": 100.0000, "estimated_amount": 2628, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2102.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 788.54, "standard_charge_percentage": 30.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1839.94, "standard_charge_percentage": 70.0000, "estimated_amount": 1839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1577.09, "standard_charge_percentage": 60.0000, "estimated_amount": 1577, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1627, "estimated_amount": 1627, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2102.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2365.63, "standard_charge_percentage": 90.0000, "estimated_amount": 2365, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1051.39, "standard_charge_percentage": 40.0000, "estimated_amount": 1051, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2102.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2102.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2497.06, "standard_charge_percentage": 95.0000, "estimated_amount": 2497, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1577.09, "standard_charge_percentage": 60.0000, "estimated_amount": 1577, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2102.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2102.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1471.95, "standard_charge_percentage": 56.0000, "estimated_amount": 1471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1971.36, "standard_charge_percentage": 75.0000, "estimated_amount": 1971, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1314.24, "standard_charge_percentage": 50.0000, "estimated_amount": 1314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1971.36, "standard_charge_percentage": 75.0000, "estimated_amount": 1971, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1839.94, "standard_charge_percentage": 70.0000, "estimated_amount": 1839, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1839.94, "standard_charge_percentage": 70.0000, "estimated_amount": 1839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2102.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2365.63, "standard_charge_percentage": 90.0000, "estimated_amount": 2365, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1971.36, "standard_charge_percentage": 75.0000, "estimated_amount": 1971, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2102.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2365.63, "standard_charge_percentage": 90.0000, "estimated_amount": 2365, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2365.63, "standard_charge_percentage": 90.0000, "estimated_amount": 2365, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2234.21, "standard_charge_percentage": 85.0000, "estimated_amount": 2234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2299.92, "standard_charge_percentage": 87.5000, "estimated_amount": 2299, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2628.48, "standard_charge_percentage": 100.0000, "estimated_amount": 2628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2102.78, "standard_charge_percentage": 80.0000, "estimated_amount": 2102, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1971.36, "standard_charge_percentage": 75.0000, "estimated_amount": 1971, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2155.35, "standard_charge_percentage": 82.0000, "estimated_amount": 2155, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1524.52, "standard_charge_percentage": 58.0000, "estimated_amount": 1524, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2365.63, "standard_charge_percentage": 90.0000, "estimated_amount": 2365, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2575.91, "standard_charge_percentage": 98.0000, "estimated_amount": 2575, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2628.48, "estimated_amount": 2628, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "28308", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5279.83, "discounted_cash": 3967,"minimum": 898,"maximum": 5279.83,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3959.87, "standard_charge_percentage": 75.0000, "estimated_amount": 3959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2639.91, "standard_charge_percentage": 50.0000, "estimated_amount": 2639, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2111.93, "standard_charge_percentage": 40.0000, "estimated_amount": 2111, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5015.84, "standard_charge_percentage": 95.0000, "estimated_amount": 5015, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5279.83, "standard_charge_percentage": 100.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3167.9, "standard_charge_percentage": 60.0000, "estimated_amount": 3167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1583.95, "standard_charge_percentage": 30.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2956.7, "standard_charge_percentage": 56.0000, "estimated_amount": 2956, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3062.3, "standard_charge_percentage": 58.0000, "estimated_amount": 3062, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5279.83, "estimated_amount": 5279, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 4751.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4751, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 4751.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4751, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3695.88, "standard_charge_percentage": 70.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3959.87, "standard_charge_percentage": 75.0000, "estimated_amount": 3959, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 4619.85, "standard_charge_percentage": 87.5000, "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3959.87, "standard_charge_percentage": 75.0000, "estimated_amount": 3959, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3695.88, "standard_charge_percentage": 70.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4329.46, "standard_charge_percentage": 82.0000, "estimated_amount": 4329, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3959.87, "standard_charge_percentage": 75.0000, "estimated_amount": 3959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3167.9, "standard_charge_percentage": 60.0000, "estimated_amount": 3167, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5279.83, "estimated_amount": 5279, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 4751.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4751, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4487.86, "standard_charge_percentage": 85.0000, "estimated_amount": 4487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 4619.85, "standard_charge_percentage": 87.5000, "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5279.83, "standard_charge_percentage": 100.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3695.88, "standard_charge_percentage": 70.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3959.87, "standard_charge_percentage": 75.0000, "estimated_amount": 3959, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 4751.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4751, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 4751.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4751, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5174.23, "standard_charge_percentage": 98.0000, "estimated_amount": 5174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5279.83, "estimated_amount": 5279, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "28310", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4106.39, "discounted_cash": 8736,"minimum": 1123,"maximum": 4106.39,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 80.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 80.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 4106.39, "standard_charge_percentage": 100.0000, "estimated_amount": 4106, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 80.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1231.92, "standard_charge_percentage": 30.0000, "estimated_amount": 1231, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3367.24, "standard_charge_percentage": 82.0000, "estimated_amount": 3367, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 80.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3695.75, "standard_charge_percentage": 90.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3079.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3079, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3695.75, "standard_charge_percentage": 90.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 80.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 4106.39, "standard_charge_percentage": 100.0000, "estimated_amount": 4106, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2874.47, "standard_charge_percentage": 70.0000, "estimated_amount": 2874, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3079.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2463.83, "standard_charge_percentage": 60.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3079.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3079, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3695.75, "standard_charge_percentage": 90.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3695.75, "standard_charge_percentage": 90.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3490.43, "standard_charge_percentage": 85.0000, "estimated_amount": 3490, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3593.09, "standard_charge_percentage": 87.5000, "estimated_amount": 3593, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 80.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3901.07, "standard_charge_percentage": 95.0000, "estimated_amount": 3901, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2463.83, "standard_charge_percentage": 60.0000, "estimated_amount": 2463, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 80.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3079.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3079, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2299.58, "standard_charge_percentage": 56.0000, "estimated_amount": 2299, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2381.71, "standard_charge_percentage": 58.0000, "estimated_amount": 2381, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 4024.26, "standard_charge_percentage": 98.0000, "estimated_amount": 4024, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3079.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3079, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 80.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2053.2, "standard_charge_percentage": 50.0000, "estimated_amount": 2053, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1642.56, "standard_charge_percentage": 40.0000, "estimated_amount": 1642, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3593.09, "standard_charge_percentage": 87.5000, "estimated_amount": 3593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 80.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3285.11, "standard_charge_percentage": 80.0000, "estimated_amount": 3285, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2874.47, "standard_charge_percentage": 70.0000, "estimated_amount": 2874, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2874.47, "standard_charge_percentage": 70.0000, "estimated_amount": 2874, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3695.75, "standard_charge_percentage": 90.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 4106.39, "estimated_amount": 4106, "methodology": "fee schedule" }]}]} , { "description": "Treat metatarsal fracture", "code_information": [ { "code": "28485", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 20504.2, "discounted_cash": 8736,"minimum": 1403,"maximum": 20504.2,"payers_information":[{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 10252.1, "standard_charge_percentage": 50.0000, "estimated_amount": 10252, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 18453.8, "standard_charge_percentage": 90.0000, "estimated_amount": 18453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 17941.2, "standard_charge_percentage": 87.5000, "estimated_amount": 17941, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 16403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16403, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 20504.2, "standard_charge_percentage": 100.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 12302.5, "standard_charge_percentage": 60.0000, "estimated_amount": 12302, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 16403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16403, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 18453.8, "standard_charge_percentage": 90.0000, "estimated_amount": 18453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 12432.4, "estimated_amount": 12432, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 13440.5, "estimated_amount": 13440, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 16403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16403, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 18453.8, "standard_charge_percentage": 90.0000, "estimated_amount": 18453, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 8201.68, "standard_charge_percentage": 40.0000, "estimated_amount": 8201, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 16403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16403, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 16403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 6151.26, "standard_charge_percentage": 30.0000, "estimated_amount": 6151, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 16813.4, "standard_charge_percentage": 82.0000, "estimated_amount": 16813, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 12302.5, "standard_charge_percentage": 60.0000, "estimated_amount": 12302, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 20504.2, "estimated_amount": 20504, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1403, "estimated_amount": 1403, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 15378.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15378, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 16403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16403, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 16403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16403, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 16403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16403, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 15378.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15378, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 11482.4, "standard_charge_percentage": 56.0000, "estimated_amount": 11482, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 11892.4, "standard_charge_percentage": 58.0000, "estimated_amount": 11892, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 20094.1, "standard_charge_percentage": 98.0000, "estimated_amount": 20094, "methodology": "percent of total billed charges" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 15378.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15378, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 18453.8, "standard_charge_percentage": 90.0000, "estimated_amount": 18453, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 17428.6, "standard_charge_percentage": 85.0000, "estimated_amount": 17428, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 17941.2, "standard_charge_percentage": 87.5000, "estimated_amount": 17941, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 16403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16403, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 19479, "standard_charge_percentage": 95.0000, "estimated_amount": 19478, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 20504.2, "standard_charge_percentage": 100.0000, "estimated_amount": 20504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 16403.4, "standard_charge_percentage": 80.0000, "estimated_amount": 16403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 15378.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15378, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 14352.9, "standard_charge_percentage": 70.0000, "estimated_amount": 14352, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 14352.9, "standard_charge_percentage": 70.0000, "estimated_amount": 14352, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 14352.9, "standard_charge_percentage": 70.0000, "estimated_amount": 14352, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 18453.8, "standard_charge_percentage": 90.0000, "estimated_amount": 18453, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 15378.2, "standard_charge_percentage": 75.0000, "estimated_amount": 15378, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Big Toe Fx W Manip", "code_information": [ { "code": "28495", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 76.39,"maximum": 1150.1,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 76.39, "estimated_amount": 76, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" }]}]} , { "description": "Treat big toe fracture", "code_information": [ { "code": "28505", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 12656.5, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 12656.5,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 10125.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10125, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 10758, "standard_charge_percentage": 85.0000, "estimated_amount": 10758, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 11074.4, "standard_charge_percentage": 87.5000, "estimated_amount": 11074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 10125.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 9492.38, "standard_charge_percentage": 75.0000, "estimated_amount": 9492, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 8859.55, "standard_charge_percentage": 70.0000, "estimated_amount": 8859, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 10378.3, "standard_charge_percentage": 82.0000, "estimated_amount": 10378, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 7340.77, "standard_charge_percentage": 58.0000, "estimated_amount": 7340, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5062.6, "standard_charge_percentage": 40.0000, "estimated_amount": 5062, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 12656.5, "standard_charge_percentage": 100.0000, "estimated_amount": 12656, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 12656.5, "standard_charge_percentage": 100.0000, "estimated_amount": 12656, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 7593.9, "standard_charge_percentage": 60.0000, "estimated_amount": 7593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 10125.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10125, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 10125.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10125, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3796.95, "standard_charge_percentage": 30.0000, "estimated_amount": 3796, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 8859.55, "standard_charge_percentage": 70.0000, "estimated_amount": 8859, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 9492.38, "standard_charge_percentage": 75.0000, "estimated_amount": 9492, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 7087.64, "standard_charge_percentage": 56.0000, "estimated_amount": 7087, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 9492.38, "standard_charge_percentage": 75.0000, "estimated_amount": 9492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 9492.38, "standard_charge_percentage": 75.0000, "estimated_amount": 9492, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 9492.38, "standard_charge_percentage": 75.0000, "estimated_amount": 9492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6328.25, "standard_charge_percentage": 50.0000, "estimated_amount": 6328, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 12023.7, "standard_charge_percentage": 95.0000, "estimated_amount": 12023, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 10125.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10125, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 8859.55, "standard_charge_percentage": 70.0000, "estimated_amount": 8859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 10125.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10125, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 12403.4, "standard_charge_percentage": 98.0000, "estimated_amount": 12403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 7593.9, "standard_charge_percentage": 60.0000, "estimated_amount": 7593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 10125.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10125, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 11390.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11390, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 11390.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11390, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 11390.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11390, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 11074.4, "standard_charge_percentage": 87.5000, "estimated_amount": 11074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 10125.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10125, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 10125.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10125, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 10125.2, "standard_charge_percentage": 80.0000, "estimated_amount": 10125, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 11390.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11390, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 11390.9, "standard_charge_percentage": 90.0000, "estimated_amount": 11390, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 10807.7, "estimated_amount": 10807, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat Toe Fx W Manip Ea", "code_information": [ { "code": "28515", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" }]}]} , { "description": "Hc Clsd Treat I-P Jt,Toe Disloc Wo Anes", "code_information": [ { "code": "28660", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1150.1, "discounted_cash": 293,"minimum": 204.5,"maximum": 1150.1,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 977.58, "standard_charge_percentage": 85.0000, "estimated_amount": 977, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1127.1, "standard_charge_percentage": 98.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1150.1, "estimated_amount": 1150, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 425.54, "standard_charge_percentage": 37.0000, "estimated_amount": 425, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 575.05, "standard_charge_percentage": 50.0000, "estimated_amount": 575, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1035.09, "standard_charge_percentage": 90.0000, "estimated_amount": 1035, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 460.04, "standard_charge_percentage": 40.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 805.07, "standard_charge_percentage": 70.0000, "estimated_amount": 805, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 943.08, "standard_charge_percentage": 82.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 644.06, "standard_charge_percentage": 56.0000, "estimated_amount": 644, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 862.58, "standard_charge_percentage": 75.0000, "estimated_amount": 862, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1006.34, "standard_charge_percentage": 87.5000, "estimated_amount": 1006, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1092.59, "standard_charge_percentage": 95.0000, "estimated_amount": 1092, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1150.1, "standard_charge_percentage": 100.0000, "estimated_amount": 1150, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 690.06, "standard_charge_percentage": 60.0000, "estimated_amount": 690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 920.08, "standard_charge_percentage": 80.0000, "estimated_amount": 920, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 345.03, "standard_charge_percentage": 30.0000, "estimated_amount": 345, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 667.06, "standard_charge_percentage": 58.0000, "estimated_amount": 667, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" }]}]} , { "description": "Amputation Toe & Metatarsal", "code_information": [ { "code": "28810", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9755.73, "discounted_cash": 3967,"minimum": 898,"maximum": 9755.73,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7804.58, "standard_charge_percentage": 80.0000, "estimated_amount": 7804, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7804.58, "standard_charge_percentage": 80.0000, "estimated_amount": 7804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2926.72, "standard_charge_percentage": 30.0000, "estimated_amount": 2926, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6829.01, "standard_charge_percentage": 70.0000, "estimated_amount": 6829, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6829.01, "standard_charge_percentage": 70.0000, "estimated_amount": 6829, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5658.32, "standard_charge_percentage": 58.0000, "estimated_amount": 5658, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8780.16, "standard_charge_percentage": 90.0000, "estimated_amount": 8780, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7316.8, "standard_charge_percentage": 75.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5853.44, "standard_charge_percentage": 60.0000, "estimated_amount": 5853, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8536.26, "standard_charge_percentage": 87.5000, "estimated_amount": 8536, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 9267.94, "standard_charge_percentage": 95.0000, "estimated_amount": 9267, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7804.58, "standard_charge_percentage": 80.0000, "estimated_amount": 7804, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7999.7, "standard_charge_percentage": 82.0000, "estimated_amount": 7999, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7804.58, "standard_charge_percentage": 80.0000, "estimated_amount": 7804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7316.8, "standard_charge_percentage": 75.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8780.16, "standard_charge_percentage": 90.0000, "estimated_amount": 8780, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8780.16, "standard_charge_percentage": 90.0000, "estimated_amount": 8780, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8536.26, "standard_charge_percentage": 87.5000, "estimated_amount": 8536, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7804.58, "standard_charge_percentage": 80.0000, "estimated_amount": 7804, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9755.73, "standard_charge_percentage": 100.0000, "estimated_amount": 9755, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5853.44, "standard_charge_percentage": 60.0000, "estimated_amount": 5853, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7804.58, "standard_charge_percentage": 80.0000, "estimated_amount": 7804, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7804.58, "standard_charge_percentage": 80.0000, "estimated_amount": 7804, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7316.8, "standard_charge_percentage": 75.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5463.21, "standard_charge_percentage": 56.0000, "estimated_amount": 5463, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8780.16, "standard_charge_percentage": 90.0000, "estimated_amount": 8780, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9560.62, "standard_charge_percentage": 98.0000, "estimated_amount": 9560, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9755.73, "estimated_amount": 9755, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7316.8, "standard_charge_percentage": 75.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7804.58, "standard_charge_percentage": 80.0000, "estimated_amount": 7804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4877.86, "standard_charge_percentage": 50.0000, "estimated_amount": 4877, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8780.16, "standard_charge_percentage": 90.0000, "estimated_amount": 8780, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 8292.37, "standard_charge_percentage": 85.0000, "estimated_amount": 8292, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3902.29, "standard_charge_percentage": 40.0000, "estimated_amount": 3902, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7804.58, "standard_charge_percentage": 80.0000, "estimated_amount": 7804, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9755.73, "standard_charge_percentage": 100.0000, "estimated_amount": 9755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7804.58, "standard_charge_percentage": 80.0000, "estimated_amount": 7804, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7316.8, "standard_charge_percentage": 75.0000, "estimated_amount": 7316, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6829.01, "standard_charge_percentage": 70.0000, "estimated_amount": 6829, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" }]}]} , { "description": "Amputation of toe", "code_information": [ { "code": "28820", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8713.67, "discounted_cash": 3967,"minimum": 898,"maximum": 8713.67,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6535.25, "standard_charge_percentage": 75.0000, "estimated_amount": 6535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6970.94, "standard_charge_percentage": 80.0000, "estimated_amount": 6970, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7406.62, "standard_charge_percentage": 85.0000, "estimated_amount": 7406, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6970.94, "standard_charge_percentage": 80.0000, "estimated_amount": 6970, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8713.67, "standard_charge_percentage": 100.0000, "estimated_amount": 8713, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8713.67, "standard_charge_percentage": 100.0000, "estimated_amount": 8713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2614.1, "standard_charge_percentage": 30.0000, "estimated_amount": 2614, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6099.57, "standard_charge_percentage": 70.0000, "estimated_amount": 6099, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4879.66, "standard_charge_percentage": 56.0000, "estimated_amount": 4879, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7842.3, "standard_charge_percentage": 90.0000, "estimated_amount": 7842, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6535.25, "standard_charge_percentage": 75.0000, "estimated_amount": 6535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7842.3, "standard_charge_percentage": 90.0000, "estimated_amount": 7842, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7624.46, "standard_charge_percentage": 87.5000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5228.2, "standard_charge_percentage": 60.0000, "estimated_amount": 5228, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6970.94, "standard_charge_percentage": 80.0000, "estimated_amount": 6970, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6970.94, "standard_charge_percentage": 80.0000, "estimated_amount": 6970, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6970.94, "standard_charge_percentage": 80.0000, "estimated_amount": 6970, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6099.57, "standard_charge_percentage": 70.0000, "estimated_amount": 6099, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8539.4, "standard_charge_percentage": 98.0000, "estimated_amount": 8539, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6970.94, "standard_charge_percentage": 80.0000, "estimated_amount": 6970, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4356.84, "standard_charge_percentage": 50.0000, "estimated_amount": 4356, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7842.3, "standard_charge_percentage": 90.0000, "estimated_amount": 7842, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3485.47, "standard_charge_percentage": 40.0000, "estimated_amount": 3485, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7624.46, "standard_charge_percentage": 87.5000, "estimated_amount": 7624, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6970.94, "standard_charge_percentage": 80.0000, "estimated_amount": 6970, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8277.99, "standard_charge_percentage": 95.0000, "estimated_amount": 8277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6535.25, "standard_charge_percentage": 75.0000, "estimated_amount": 6535, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7145.21, "standard_charge_percentage": 82.0000, "estimated_amount": 7145, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5053.93, "standard_charge_percentage": 58.0000, "estimated_amount": 5053, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6970.94, "standard_charge_percentage": 80.0000, "estimated_amount": 6970, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7842.3, "standard_charge_percentage": 90.0000, "estimated_amount": 7842, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5228.2, "standard_charge_percentage": 60.0000, "estimated_amount": 5228, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 8713.67, "estimated_amount": 8713, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6535.25, "standard_charge_percentage": 75.0000, "estimated_amount": 6535, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7842.3, "standard_charge_percentage": 90.0000, "estimated_amount": 7842, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6970.94, "standard_charge_percentage": 80.0000, "estimated_amount": 6970, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6970.94, "standard_charge_percentage": 80.0000, "estimated_amount": 6970, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6099.57, "standard_charge_percentage": 70.0000, "estimated_amount": 6099, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6535.25, "standard_charge_percentage": 75.0000, "estimated_amount": 6535, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" }]}]} , { "description": "Partial amputation of toe", "code_information": [ { "code": "28825", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8670.96, "discounted_cash": 3967,"minimum": 898,"maximum": 8670.96,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7803.86, "standard_charge_percentage": 90.0000, "estimated_amount": 7803, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7803.86, "standard_charge_percentage": 90.0000, "estimated_amount": 7803, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6936.77, "standard_charge_percentage": 80.0000, "estimated_amount": 6936, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6936.77, "standard_charge_percentage": 80.0000, "estimated_amount": 6936, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6936.77, "standard_charge_percentage": 80.0000, "estimated_amount": 6936, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6936.77, "standard_charge_percentage": 80.0000, "estimated_amount": 6936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6503.22, "standard_charge_percentage": 75.0000, "estimated_amount": 6503, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6069.67, "standard_charge_percentage": 70.0000, "estimated_amount": 6069, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6069.67, "standard_charge_percentage": 70.0000, "estimated_amount": 6069, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7110.19, "standard_charge_percentage": 82.0000, "estimated_amount": 7110, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5029.16, "standard_charge_percentage": 58.0000, "estimated_amount": 5029, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6936.77, "standard_charge_percentage": 80.0000, "estimated_amount": 6936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6503.22, "standard_charge_percentage": 75.0000, "estimated_amount": 6503, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6503.22, "standard_charge_percentage": 75.0000, "estimated_amount": 6503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4335.48, "standard_charge_percentage": 50.0000, "estimated_amount": 4335, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7803.86, "standard_charge_percentage": 90.0000, "estimated_amount": 7803, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6936.77, "standard_charge_percentage": 80.0000, "estimated_amount": 6936, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6936.77, "standard_charge_percentage": 80.0000, "estimated_amount": 6936, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8670.96, "standard_charge_percentage": 100.0000, "estimated_amount": 8670, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7803.86, "standard_charge_percentage": 90.0000, "estimated_amount": 7803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3468.38, "standard_charge_percentage": 40.0000, "estimated_amount": 3468, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8237.41, "standard_charge_percentage": 95.0000, "estimated_amount": 8237, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6936.77, "standard_charge_percentage": 80.0000, "estimated_amount": 6936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5202.58, "standard_charge_percentage": 60.0000, "estimated_amount": 5202, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6936.77, "standard_charge_percentage": 80.0000, "estimated_amount": 6936, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6936.77, "standard_charge_percentage": 80.0000, "estimated_amount": 6936, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7370.32, "standard_charge_percentage": 85.0000, "estimated_amount": 7370, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7587.09, "standard_charge_percentage": 87.5000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7587.09, "standard_charge_percentage": 87.5000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8670.96, "standard_charge_percentage": 100.0000, "estimated_amount": 8670, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5202.58, "standard_charge_percentage": 60.0000, "estimated_amount": 5202, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2601.29, "standard_charge_percentage": 30.0000, "estimated_amount": 2601, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6069.67, "standard_charge_percentage": 70.0000, "estimated_amount": 6069, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6503.22, "standard_charge_percentage": 75.0000, "estimated_amount": 6503, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4855.74, "standard_charge_percentage": 56.0000, "estimated_amount": 4855, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7803.86, "standard_charge_percentage": 90.0000, "estimated_amount": 7803, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8497.54, "standard_charge_percentage": 98.0000, "estimated_amount": 8497, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6503.22, "standard_charge_percentage": 75.0000, "estimated_amount": 6503, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 8670.96, "estimated_amount": 8670, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "28899", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5279.83, "discounted_cash": 293,"minimum": 125.74,"maximum": 5279.83,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 125.74, "estimated_amount": 125, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2639.91, "standard_charge_percentage": 50.0000, "estimated_amount": 2639, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 4751.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4751, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4487.86, "standard_charge_percentage": 85.0000, "estimated_amount": 4487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 4619.85, "standard_charge_percentage": 87.5000, "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5279.83, "standard_charge_percentage": 100.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3062.3, "standard_charge_percentage": 58.0000, "estimated_amount": 3062, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3959.87, "standard_charge_percentage": 75.0000, "estimated_amount": 3959, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 304.63, "estimated_amount": 304, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 315.91, "estimated_amount": 315, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 417.45, "estimated_amount": 417, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 451.3, "estimated_amount": 451, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 204.5, "estimated_amount": 204, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.55, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 4751.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4751, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 4751.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4751, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2111.93, "standard_charge_percentage": 40.0000, "estimated_amount": 2111, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 4619.85, "standard_charge_percentage": 87.5000, "estimated_amount": 4619, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5015.84, "standard_charge_percentage": 95.0000, "estimated_amount": 5015, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3695.88, "standard_charge_percentage": 70.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3695.88, "standard_charge_percentage": 70.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2956.7, "standard_charge_percentage": 56.0000, "estimated_amount": 2956, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3167.9, "standard_charge_percentage": 60.0000, "estimated_amount": 3167, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 799, "estimated_amount": 799, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 361.04, "estimated_amount": 361, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 296.52, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 292.44, "estimated_amount": 292, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3959.87, "standard_charge_percentage": 75.0000, "estimated_amount": 3959, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3959.87, "standard_charge_percentage": 75.0000, "estimated_amount": 3959, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5279.83, "standard_charge_percentage": 100.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1583.95, "standard_charge_percentage": 30.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3695.88, "standard_charge_percentage": 70.0000, "estimated_amount": 3695, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3959.87, "standard_charge_percentage": 75.0000, "estimated_amount": 3959, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 4751.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4751, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 4751.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4751, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5174.23, "standard_charge_percentage": 98.0000, "estimated_amount": 5174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 294.48, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3167.9, "standard_charge_percentage": 60.0000, "estimated_amount": 3167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3959.87, "standard_charge_percentage": 75.0000, "estimated_amount": 3959, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4329.46, "standard_charge_percentage": 82.0000, "estimated_amount": 4329, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1953.54, "standard_charge_percentage": 37.0000, "estimated_amount": 1953, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4223.86, "standard_charge_percentage": 80.0000, "estimated_amount": 4223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 225.65, "estimated_amount": 225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 230.16, "estimated_amount": 230, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 236.93, "estimated_amount": 236, "methodology": "fee schedule" }]}]} , { "description": "Hc Apply Long Arm Splint", "code_information": [ { "code": "29105", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 788.34, "discounted_cash": 192,"minimum": 134.52,"maximum": 788.34,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 193.71, "estimated_amount": 193, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 195.05, "estimated_amount": 195, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 689.8, "standard_charge_percentage": 87.5000, "estimated_amount": 689, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 788.34, "standard_charge_percentage": 100.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 236.5, "standard_charge_percentage": 30.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 772.57, "standard_charge_percentage": 98.0000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 473, "standard_charge_percentage": 60.0000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 274.6, "estimated_amount": 274, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 192.36, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 394.17, "standard_charge_percentage": 50.0000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 394.17, "standard_charge_percentage": 50.0000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 315.34, "standard_charge_percentage": 40.0000, "estimated_amount": 315, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 473, "standard_charge_percentage": 60.0000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 646.44, "standard_charge_percentage": 82.0000, "estimated_amount": 646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 525.57, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 670.09, "standard_charge_percentage": 85.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 689.8, "standard_charge_percentage": 87.5000, "estimated_amount": 689, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 788.34, "standard_charge_percentage": 100.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 457.24, "standard_charge_percentage": 58.0000, "estimated_amount": 457, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 291.69, "standard_charge_percentage": 37.0000, "estimated_amount": 291, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 296.86, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 146.14, "estimated_amount": 146, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 748.92, "standard_charge_percentage": 95.0000, "estimated_amount": 748, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 441.47, "standard_charge_percentage": 56.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 151.4, "estimated_amount": 151, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 200.38, "estimated_amount": 200, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" }]}]} , { "description": "Hc Apply Forearm Splint Static", "code_information": [ { "code": "29125", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 629.19, "discounted_cash": 157,"minimum": 109.89,"maximum": 629.19,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 616.61, "standard_charge_percentage": 98.0000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 534.81, "standard_charge_percentage": 85.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 188.76, "standard_charge_percentage": 30.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 515.94, "standard_charge_percentage": 82.0000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 232.8, "standard_charge_percentage": 37.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 364.93, "standard_charge_percentage": 58.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 251.68, "standard_charge_percentage": 40.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 597.73, "standard_charge_percentage": 95.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 352.35, "standard_charge_percentage": 56.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" }]}]} , { "description": "Hc Apply Forearm Splint", "code_information": [ { "code": "29126", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 629.19, "discounted_cash": 157,"minimum": 109.89,"maximum": 629.19,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 534.81, "standard_charge_percentage": 85.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 188.76, "standard_charge_percentage": 30.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 515.94, "standard_charge_percentage": 82.0000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 251.68, "standard_charge_percentage": 40.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 597.73, "standard_charge_percentage": 95.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 352.35, "standard_charge_percentage": 56.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 232.8, "standard_charge_percentage": 37.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 616.61, "standard_charge_percentage": 98.0000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 364.93, "standard_charge_percentage": 58.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" }]}]} , { "description": "Hc Apply Finger Splint Static", "code_information": [ { "code": "29130", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 629.19, "discounted_cash": 157,"minimum": 41.38,"maximum": 629.19,"payers_information":[{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 534.81, "standard_charge_percentage": 85.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 597.73, "standard_charge_percentage": 95.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 188.76, "standard_charge_percentage": 30.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 41.38, "estimated_amount": 41, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 364.93, "standard_charge_percentage": 58.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 251.68, "standard_charge_percentage": 40.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 515.94, "standard_charge_percentage": 82.0000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 352.35, "standard_charge_percentage": 56.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 232.8, "standard_charge_percentage": 37.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 616.61, "standard_charge_percentage": 98.0000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" }]}]} , { "description": "Hc Strapping Shoulder", "code_information": [ { "code": "29240", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 469.31, "discounted_cash": 157,"minimum": 41.38,"maximum": 469.31,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 422.38, "standard_charge_percentage": 90.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 410.65, "standard_charge_percentage": 87.5000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 445.84, "standard_charge_percentage": 95.0000, "estimated_amount": 445, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 469.31, "standard_charge_percentage": 100.0000, "estimated_amount": 469, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 281.59, "standard_charge_percentage": 60.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 375.45, "standard_charge_percentage": 80.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 328.52, "standard_charge_percentage": 70.0000, "estimated_amount": 328, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 272.2, "standard_charge_percentage": 58.0000, "estimated_amount": 272, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 422.38, "standard_charge_percentage": 90.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 422.38, "standard_charge_percentage": 90.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 351.98, "standard_charge_percentage": 75.0000, "estimated_amount": 351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 281.59, "standard_charge_percentage": 60.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 41.38, "estimated_amount": 41, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 375.45, "standard_charge_percentage": 80.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 351.98, "standard_charge_percentage": 75.0000, "estimated_amount": 351, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 398.91, "standard_charge_percentage": 85.0000, "estimated_amount": 398, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 187.72, "standard_charge_percentage": 40.0000, "estimated_amount": 187, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 375.45, "standard_charge_percentage": 80.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 351.98, "standard_charge_percentage": 75.0000, "estimated_amount": 351, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 234.66, "standard_charge_percentage": 50.0000, "estimated_amount": 234, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 375.45, "standard_charge_percentage": 80.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 422.38, "standard_charge_percentage": 90.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 422.38, "standard_charge_percentage": 90.0000, "estimated_amount": 422, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 375.45, "standard_charge_percentage": 80.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 469.31, "standard_charge_percentage": 100.0000, "estimated_amount": 469, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 375.45, "standard_charge_percentage": 80.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 140.79, "standard_charge_percentage": 30.0000, "estimated_amount": 140, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 328.52, "standard_charge_percentage": 70.0000, "estimated_amount": 328, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 328.52, "standard_charge_percentage": 70.0000, "estimated_amount": 328, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 351.98, "standard_charge_percentage": 75.0000, "estimated_amount": 351, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 384.83, "standard_charge_percentage": 82.0000, "estimated_amount": 384, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 262.81, "standard_charge_percentage": 56.0000, "estimated_amount": 262, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 173.64, "standard_charge_percentage": 37.0000, "estimated_amount": 173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 375.45, "standard_charge_percentage": 80.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 459.92, "standard_charge_percentage": 98.0000, "estimated_amount": 459, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 351.98, "standard_charge_percentage": 75.0000, "estimated_amount": 351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 234.66, "standard_charge_percentage": 50.0000, "estimated_amount": 234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 410.65, "standard_charge_percentage": 87.5000, "estimated_amount": 410, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 375.45, "standard_charge_percentage": 80.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 375.45, "standard_charge_percentage": 80.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 375.45, "standard_charge_percentage": 80.0000, "estimated_amount": 375, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" }]}]} , { "description": "Hc Strapping Elbow Or Wrist", "code_information": [ { "code": "29260", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 310.61, "discounted_cash": 72,"minimum": 25.17,"maximum": 310.61,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 57.63, "estimated_amount": 57, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 50.63, "estimated_amount": 50, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 155.31, "standard_charge_percentage": 50.0000, "estimated_amount": 155, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 232.96, "standard_charge_percentage": 75.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 279.55, "standard_charge_percentage": 90.0000, "estimated_amount": 279, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 279.55, "standard_charge_percentage": 90.0000, "estimated_amount": 279, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 264.02, "standard_charge_percentage": 85.0000, "estimated_amount": 264, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 124.24, "standard_charge_percentage": 40.0000, "estimated_amount": 124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 248.49, "standard_charge_percentage": 80.0000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 248.49, "standard_charge_percentage": 80.0000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 93.18, "standard_charge_percentage": 30.0000, "estimated_amount": 93, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 279.55, "standard_charge_percentage": 90.0000, "estimated_amount": 279, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 232.96, "standard_charge_percentage": 75.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 186.37, "standard_charge_percentage": 60.0000, "estimated_amount": 186, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 78.22, "estimated_amount": 78, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 58.66, "estimated_amount": 58, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 103.36, "estimated_amount": 103, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 72.91, "estimated_amount": 72, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 50.63, "estimated_amount": 50, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 155.31, "standard_charge_percentage": 50.0000, "estimated_amount": 155, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 279.55, "standard_charge_percentage": 90.0000, "estimated_amount": 279, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 271.78, "standard_charge_percentage": 87.5000, "estimated_amount": 271, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 248.49, "standard_charge_percentage": 80.0000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 248.49, "standard_charge_percentage": 80.0000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 186.37, "standard_charge_percentage": 60.0000, "estimated_amount": 186, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 248.49, "standard_charge_percentage": 80.0000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 248.49, "standard_charge_percentage": 80.0000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 217.43, "standard_charge_percentage": 70.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 180.15, "standard_charge_percentage": 58.0000, "estimated_amount": 180, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 304.4, "standard_charge_percentage": 98.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 197.83, "estimated_amount": 197, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 58.66, "estimated_amount": 58, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 72.4, "estimated_amount": 72, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 232.96, "standard_charge_percentage": 75.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 248.49, "standard_charge_percentage": 80.0000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 271.78, "standard_charge_percentage": 87.5000, "estimated_amount": 271, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 248.49, "standard_charge_percentage": 80.0000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 310.61, "standard_charge_percentage": 100.0000, "estimated_amount": 310, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 295.08, "standard_charge_percentage": 95.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 217.43, "standard_charge_percentage": 70.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 217.43, "standard_charge_percentage": 70.0000, "estimated_amount": 217, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 232.96, "standard_charge_percentage": 75.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 114.93, "standard_charge_percentage": 37.0000, "estimated_amount": 114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 248.49, "standard_charge_percentage": 80.0000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 56.99, "estimated_amount": 56, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 75.42, "estimated_amount": 75, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 111.74, "estimated_amount": 111, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 25.17, "estimated_amount": 25, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 73.41, "estimated_amount": 73, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 248.49, "standard_charge_percentage": 80.0000, "estimated_amount": 248, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 310.61, "standard_charge_percentage": 100.0000, "estimated_amount": 310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 232.96, "standard_charge_percentage": 75.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 254.7, "standard_charge_percentage": 82.0000, "estimated_amount": 254, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 173.94, "standard_charge_percentage": 56.0000, "estimated_amount": 173, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 279.55, "standard_charge_percentage": 90.0000, "estimated_amount": 279, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 89.39, "estimated_amount": 89, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 78.22, "estimated_amount": 78, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 89.39, "estimated_amount": 89, "methodology": "fee schedule" }]}]} , { "description": "Hc Strapping Hand Or Finger", "code_information": [ { "code": "29280", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 304.9, "discounted_cash": 72,"minimum": 22.85,"maximum": 304.9,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 57.63, "estimated_amount": 57, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 50.63, "estimated_amount": 50, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 72.4, "estimated_amount": 72, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 243.92, "standard_charge_percentage": 80.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 228.68, "standard_charge_percentage": 75.0000, "estimated_amount": 228, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 243.92, "standard_charge_percentage": 80.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 91.47, "standard_charge_percentage": 30.0000, "estimated_amount": 91, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 111.74, "estimated_amount": 111, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 72.91, "estimated_amount": 72, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 50.63, "estimated_amount": 50, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 73.41, "estimated_amount": 73, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 152.45, "standard_charge_percentage": 50.0000, "estimated_amount": 152, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 152.45, "standard_charge_percentage": 50.0000, "estimated_amount": 152, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 274.41, "standard_charge_percentage": 90.0000, "estimated_amount": 274, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 243.92, "standard_charge_percentage": 80.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 298.8, "standard_charge_percentage": 98.0000, "estimated_amount": 298, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 228.68, "standard_charge_percentage": 75.0000, "estimated_amount": 228, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 182.94, "standard_charge_percentage": 60.0000, "estimated_amount": 182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 56.99, "estimated_amount": 56, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 75.42, "estimated_amount": 75, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 89.39, "estimated_amount": 89, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 22.85, "estimated_amount": 22, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 259.16, "standard_charge_percentage": 85.0000, "estimated_amount": 259, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 121.96, "standard_charge_percentage": 40.0000, "estimated_amount": 121, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 266.79, "standard_charge_percentage": 87.5000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 266.79, "standard_charge_percentage": 87.5000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 243.92, "standard_charge_percentage": 80.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 243.92, "standard_charge_percentage": 80.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 304.9, "standard_charge_percentage": 100.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 289.65, "standard_charge_percentage": 95.0000, "estimated_amount": 289, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 182.94, "standard_charge_percentage": 60.0000, "estimated_amount": 182, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 213.43, "standard_charge_percentage": 70.0000, "estimated_amount": 213, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 213.43, "standard_charge_percentage": 70.0000, "estimated_amount": 213, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 228.68, "standard_charge_percentage": 75.0000, "estimated_amount": 228, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 250.02, "standard_charge_percentage": 82.0000, "estimated_amount": 250, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 112.81, "standard_charge_percentage": 37.0000, "estimated_amount": 112, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 197.83, "estimated_amount": 197, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 58.66, "estimated_amount": 58, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 78.22, "estimated_amount": 78, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 89.39, "estimated_amount": 89, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 228.68, "standard_charge_percentage": 75.0000, "estimated_amount": 228, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 243.92, "standard_charge_percentage": 80.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 274.41, "standard_charge_percentage": 90.0000, "estimated_amount": 274, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 274.41, "standard_charge_percentage": 90.0000, "estimated_amount": 274, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 243.92, "standard_charge_percentage": 80.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 304.9, "standard_charge_percentage": 100.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 243.92, "standard_charge_percentage": 80.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 243.92, "standard_charge_percentage": 80.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 228.68, "standard_charge_percentage": 75.0000, "estimated_amount": 228, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 213.43, "standard_charge_percentage": 70.0000, "estimated_amount": 213, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 170.74, "standard_charge_percentage": 56.0000, "estimated_amount": 170, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 176.84, "standard_charge_percentage": 58.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 243.92, "standard_charge_percentage": 80.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 274.41, "standard_charge_percentage": 90.0000, "estimated_amount": 274, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 274.41, "standard_charge_percentage": 90.0000, "estimated_amount": 274, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 78.22, "estimated_amount": 78, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 58.66, "estimated_amount": 58, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 103.36, "estimated_amount": 103, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 55.87, "estimated_amount": 55, "methodology": "fee schedule" }]}]} , { "description": "Hc Apply Rigid Leg Cast", "code_information": [ { "code": "29445", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1272.61, "discounted_cash": 324,"minimum": 226.4,"maximum": 1272.61,"payers_information":[{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1018.09, "standard_charge_percentage": 80.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1145.35, "standard_charge_percentage": 90.0000, "estimated_amount": 1145, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1145.35, "standard_charge_percentage": 90.0000, "estimated_amount": 1145, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1081.72, "standard_charge_percentage": 85.0000, "estimated_amount": 1081, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 509.04, "standard_charge_percentage": 40.0000, "estimated_amount": 509, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1113.53, "standard_charge_percentage": 87.5000, "estimated_amount": 1113, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1113.53, "standard_charge_percentage": 87.5000, "estimated_amount": 1113, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1208.98, "standard_charge_percentage": 95.0000, "estimated_amount": 1208, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 763.57, "standard_charge_percentage": 60.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1018.09, "standard_charge_percentage": 80.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1018.09, "standard_charge_percentage": 80.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 954.46, "standard_charge_percentage": 75.0000, "estimated_amount": 954, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 890.83, "standard_charge_percentage": 70.0000, "estimated_amount": 890, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 470.87, "standard_charge_percentage": 37.0000, "estimated_amount": 470, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1145.35, "standard_charge_percentage": 90.0000, "estimated_amount": 1145, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 249.83, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 249.83, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 462.19, "estimated_amount": 462, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 499.66, "estimated_amount": 499, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 226.4, "estimated_amount": 226, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 228.8, "estimated_amount": 228, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 323.75, "estimated_amount": 323, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 636.3, "standard_charge_percentage": 50.0000, "estimated_amount": 636, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 954.46, "standard_charge_percentage": 75.0000, "estimated_amount": 954, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1018.09, "standard_charge_percentage": 80.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1145.35, "standard_charge_percentage": 90.0000, "estimated_amount": 1145, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1018.09, "standard_charge_percentage": 80.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1018.09, "standard_charge_percentage": 80.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1272.61, "standard_charge_percentage": 100.0000, "estimated_amount": 1272, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1043.54, "standard_charge_percentage": 82.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 712.66, "standard_charge_percentage": 56.0000, "estimated_amount": 712, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 884.61, "estimated_amount": 884, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 249.83, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 249.83, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 326.02, "estimated_amount": 326, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 226.4, "estimated_amount": 226, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1018.09, "standard_charge_percentage": 80.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 890.83, "standard_charge_percentage": 70.0000, "estimated_amount": 890, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 738.11, "standard_charge_percentage": 58.0000, "estimated_amount": 738, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1018.09, "standard_charge_percentage": 80.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1247.16, "standard_charge_percentage": 98.0000, "estimated_amount": 1247, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 763.57, "standard_charge_percentage": 60.0000, "estimated_amount": 763, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 249.83, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 349.76, "estimated_amount": 349, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 262.32, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 254.83, "estimated_amount": 254, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 249.83, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 262.32, "estimated_amount": 262, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 249.83, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 349.76, "estimated_amount": 349, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 240.54, "estimated_amount": 240, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 328.28, "estimated_amount": 328, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 954.46, "standard_charge_percentage": 75.0000, "estimated_amount": 954, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 636.3, "standard_charge_percentage": 50.0000, "estimated_amount": 636, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1018.09, "standard_charge_percentage": 80.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1272.61, "standard_charge_percentage": 100.0000, "estimated_amount": 1272, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1018.09, "standard_charge_percentage": 80.0000, "estimated_amount": 1018, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 381.78, "standard_charge_percentage": 30.0000, "estimated_amount": 381, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 890.83, "standard_charge_percentage": 70.0000, "estimated_amount": 890, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 954.46, "standard_charge_percentage": 75.0000, "estimated_amount": 954, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1145.35, "standard_charge_percentage": 90.0000, "estimated_amount": 1145, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 954.46, "standard_charge_percentage": 75.0000, "estimated_amount": 954, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 249.83, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 249.83, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 337.27, "estimated_amount": 337, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 399.73, "estimated_amount": 399, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 249.83, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 399.73, "estimated_amount": 399, "methodology": "fee schedule" }]}]} , { "description": "Hc Apply Long Leg Splint", "code_information": [ { "code": "29505", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 788.34, "discounted_cash": 192,"minimum": 134.52,"maximum": 788.34,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 192.36, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 394.17, "standard_charge_percentage": 50.0000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 315.34, "standard_charge_percentage": 40.0000, "estimated_amount": 315, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 788.34, "standard_charge_percentage": 100.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 646.44, "standard_charge_percentage": 82.0000, "estimated_amount": 646, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 441.47, "standard_charge_percentage": 56.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 457.24, "standard_charge_percentage": 58.0000, "estimated_amount": 457, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 274.6, "estimated_amount": 274, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 689.8, "standard_charge_percentage": 87.5000, "estimated_amount": 689, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 236.5, "standard_charge_percentage": 30.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 291.69, "standard_charge_percentage": 37.0000, "estimated_amount": 291, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 772.57, "standard_charge_percentage": 98.0000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 525.57, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 151.4, "estimated_amount": 151, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 193.71, "estimated_amount": 193, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 146.14, "estimated_amount": 146, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 195.05, "estimated_amount": 195, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 394.17, "standard_charge_percentage": 50.0000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 788.34, "standard_charge_percentage": 100.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 748.92, "standard_charge_percentage": 95.0000, "estimated_amount": 748, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 473, "standard_charge_percentage": 60.0000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 473, "standard_charge_percentage": 60.0000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 296.86, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 670.09, "standard_charge_percentage": 85.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 689.8, "standard_charge_percentage": 87.5000, "estimated_amount": 689, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 200.38, "estimated_amount": 200, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" }]}]} , { "description": "Hc Apply Lower Leg Splint", "code_information": [ { "code": "29515", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 788.34, "discounted_cash": 192,"minimum": 134.52,"maximum": 788.34,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 146.14, "estimated_amount": 146, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 192.36, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 394.17, "standard_charge_percentage": 50.0000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 394.17, "standard_charge_percentage": 50.0000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 646.44, "standard_charge_percentage": 82.0000, "estimated_amount": 646, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 441.47, "standard_charge_percentage": 56.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 274.6, "estimated_amount": 274, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 296.86, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 193.71, "estimated_amount": 193, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 670.09, "standard_charge_percentage": 85.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 236.5, "standard_charge_percentage": 30.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 457.24, "standard_charge_percentage": 58.0000, "estimated_amount": 457, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 291.69, "standard_charge_percentage": 37.0000, "estimated_amount": 291, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 772.57, "standard_charge_percentage": 98.0000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 473, "standard_charge_percentage": 60.0000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 151.4, "estimated_amount": 151, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 200.38, "estimated_amount": 200, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 195.05, "estimated_amount": 195, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 315.34, "standard_charge_percentage": 40.0000, "estimated_amount": 315, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 788.34, "standard_charge_percentage": 100.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 748.92, "standard_charge_percentage": 95.0000, "estimated_amount": 748, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 689.8, "standard_charge_percentage": 87.5000, "estimated_amount": 689, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 689.8, "standard_charge_percentage": 87.5000, "estimated_amount": 689, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 788.34, "standard_charge_percentage": 100.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 473, "standard_charge_percentage": 60.0000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 525.57, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" }]}]} , { "description": "Hc Strapping Knee", "code_information": [ { "code": "29530", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 629.19, "discounted_cash": 157,"minimum": 109.89,"maximum": 629.19,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 534.81, "standard_charge_percentage": 85.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 352.35, "standard_charge_percentage": 56.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 616.61, "standard_charge_percentage": 98.0000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 251.68, "standard_charge_percentage": 40.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 597.73, "standard_charge_percentage": 95.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 188.76, "standard_charge_percentage": 30.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 515.94, "standard_charge_percentage": 82.0000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 364.93, "standard_charge_percentage": 58.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 232.8, "standard_charge_percentage": 37.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" }]}]} , { "description": "Hc Strapping Of Ankle And/Or Ft", "code_information": [ { "code": "29540", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 788.34, "discounted_cash": 192,"minimum": 134.52,"maximum": 788.34,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 192.36, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 394.17, "standard_charge_percentage": 50.0000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 394.17, "standard_charge_percentage": 50.0000, "estimated_amount": 394, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 315.34, "standard_charge_percentage": 40.0000, "estimated_amount": 315, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 473, "standard_charge_percentage": 60.0000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 441.47, "standard_charge_percentage": 56.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 689.8, "standard_charge_percentage": 87.5000, "estimated_amount": 689, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 291.69, "standard_charge_percentage": 37.0000, "estimated_amount": 291, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 772.57, "standard_charge_percentage": 98.0000, "estimated_amount": 772, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 473, "standard_charge_percentage": 60.0000, "estimated_amount": 473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 151.4, "estimated_amount": 151, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 200.38, "estimated_amount": 200, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 193.71, "estimated_amount": 193, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 146.14, "estimated_amount": 146, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 195.05, "estimated_amount": 195, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 788.34, "standard_charge_percentage": 100.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 748.92, "standard_charge_percentage": 95.0000, "estimated_amount": 748, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 551.84, "standard_charge_percentage": 70.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 646.44, "standard_charge_percentage": 82.0000, "estimated_amount": 646, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 591.25, "standard_charge_percentage": 75.0000, "estimated_amount": 591, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 670.09, "standard_charge_percentage": 85.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 689.8, "standard_charge_percentage": 87.5000, "estimated_amount": 689, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 788.34, "standard_charge_percentage": 100.0000, "estimated_amount": 788, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 630.67, "standard_charge_percentage": 80.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 236.5, "standard_charge_percentage": 30.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 457.24, "standard_charge_percentage": 58.0000, "estimated_amount": 457, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 709.51, "standard_charge_percentage": 90.0000, "estimated_amount": 709, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 525.57, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 274.6, "estimated_amount": 274, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 296.86, "estimated_amount": 296, "methodology": "fee schedule" }]}]} , { "description": "Hc Strapping Unna Boot", "code_information": [ { "code": "29580", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 761.85, "discounted_cash": 192,"minimum": 52,"maximum": 761.85,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 193.71, "estimated_amount": 193, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 195.05, "estimated_amount": 195, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 380.93, "standard_charge_percentage": 50.0000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 380.93, "standard_charge_percentage": 50.0000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 228.56, "standard_charge_percentage": 30.0000, "estimated_amount": 228, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 533.29, "standard_charge_percentage": 70.0000, "estimated_amount": 533, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 441.87, "standard_charge_percentage": 58.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 685.66, "standard_charge_percentage": 90.0000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 571.39, "standard_charge_percentage": 75.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 457.11, "standard_charge_percentage": 60.0000, "estimated_amount": 457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 296.86, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 685.66, "standard_charge_percentage": 90.0000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 647.57, "standard_charge_percentage": 85.0000, "estimated_amount": 647, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 304.74, "standard_charge_percentage": 40.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 666.62, "standard_charge_percentage": 87.5000, "estimated_amount": 666, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 457.11, "standard_charge_percentage": 60.0000, "estimated_amount": 457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 533.29, "standard_charge_percentage": 70.0000, "estimated_amount": 533, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 281.88, "standard_charge_percentage": 37.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 380.93, "standard_charge_percentage": 50.0000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 274.6, "estimated_amount": 274, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 296.86, "estimated_amount": 296, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 146.14, "estimated_amount": 146, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 57.2, "estimated_amount": 57, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 666.62, "standard_charge_percentage": 87.5000, "estimated_amount": 666, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 723.76, "standard_charge_percentage": 95.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 761.85, "standard_charge_percentage": 100.0000, "estimated_amount": 761, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 571.39, "standard_charge_percentage": 75.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 533.29, "standard_charge_percentage": 70.0000, "estimated_amount": 533, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 200.38, "estimated_amount": 200, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 52, "estimated_amount": 52, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 192.36, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 571.39, "standard_charge_percentage": 75.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 685.66, "standard_charge_percentage": 90.0000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 685.66, "standard_charge_percentage": 90.0000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 647.57, "standard_charge_percentage": 85.0000, "estimated_amount": 647, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 666.62, "standard_charge_percentage": 87.5000, "estimated_amount": 666, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 457.11, "standard_charge_percentage": 60.0000, "estimated_amount": 457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 533.29, "standard_charge_percentage": 70.0000, "estimated_amount": 533, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 571.39, "standard_charge_percentage": 75.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 624.72, "standard_charge_percentage": 82.0000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 426.64, "standard_charge_percentage": 56.0000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 281.88, "standard_charge_percentage": 37.0000, "estimated_amount": 281, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 746.61, "standard_charge_percentage": 98.0000, "estimated_amount": 746, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 151.4, "estimated_amount": 151, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 571.39, "standard_charge_percentage": 75.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 685.66, "standard_charge_percentage": 90.0000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 304.74, "standard_charge_percentage": 40.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 761.85, "standard_charge_percentage": 100.0000, "estimated_amount": 761, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 685.66, "standard_charge_percentage": 90.0000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 525.57, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 274.6, "estimated_amount": 274, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 52, "estimated_amount": 52, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 192.36, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 571.39, "standard_charge_percentage": 75.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 571.39, "standard_charge_percentage": 75.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 666.62, "standard_charge_percentage": 87.5000, "estimated_amount": 666, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 761.85, "standard_charge_percentage": 100.0000, "estimated_amount": 761, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 761.85, "standard_charge_percentage": 100.0000, "estimated_amount": 761, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 533.29, "standard_charge_percentage": 70.0000, "estimated_amount": 533, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 571.39, "standard_charge_percentage": 75.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 624.72, "standard_charge_percentage": 82.0000, "estimated_amount": 624, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 525.57, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 151.4, "estimated_amount": 151, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 57.2, "estimated_amount": 57, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 685.66, "standard_charge_percentage": 90.0000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 685.66, "standard_charge_percentage": 90.0000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 723.76, "standard_charge_percentage": 95.0000, "estimated_amount": 723, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 571.39, "standard_charge_percentage": 75.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 533.29, "standard_charge_percentage": 70.0000, "estimated_amount": 533, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 426.64, "standard_charge_percentage": 56.0000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 609.48, "standard_charge_percentage": 80.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 746.61, "standard_charge_percentage": 98.0000, "estimated_amount": 746, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 571.39, "standard_charge_percentage": 75.0000, "estimated_amount": 571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 457.11, "standard_charge_percentage": 60.0000, "estimated_amount": 457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 200.38, "estimated_amount": 200, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 193.71, "estimated_amount": 193, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 146.14, "estimated_amount": 146, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 195.05, "estimated_amount": 195, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 380.93, "standard_charge_percentage": 50.0000, "estimated_amount": 380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 228.56, "standard_charge_percentage": 30.0000, "estimated_amount": 228, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 441.87, "standard_charge_percentage": 58.0000, "estimated_amount": 441, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 685.66, "standard_charge_percentage": 90.0000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 685.66, "standard_charge_percentage": 90.0000, "estimated_amount": 685, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" }]}]} , { "description": "Hc Apply Multlay Comprs Lwr Leg", "code_information": [ { "code": "29581", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1140.48, "discounted_cash": 192,"minimum": 38.17,"maximum": 1140.48,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 193.71, "estimated_amount": 193, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 38.17, "estimated_amount": 38, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 38.17, "estimated_amount": 38, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 855.36, "standard_charge_percentage": 75.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 912.38, "standard_charge_percentage": 80.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1026.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1026, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 456.19, "standard_charge_percentage": 40.0000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 912.38, "standard_charge_percentage": 80.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1140.48, "standard_charge_percentage": 100.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 912.38, "standard_charge_percentage": 80.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 855.36, "standard_charge_percentage": 75.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 855.36, "standard_charge_percentage": 75.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 935.19, "standard_charge_percentage": 82.0000, "estimated_amount": 935, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 661.48, "standard_charge_percentage": 58.0000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 525.57, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 151.4, "estimated_amount": 151, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 200.38, "estimated_amount": 200, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 146.14, "estimated_amount": 146, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 192.36, "estimated_amount": 192, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 570.24, "standard_charge_percentage": 50.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1026.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1026, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 912.38, "standard_charge_percentage": 80.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1083.46, "standard_charge_percentage": 95.0000, "estimated_amount": 1083, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 684.29, "standard_charge_percentage": 60.0000, "estimated_amount": 684, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 912.38, "standard_charge_percentage": 80.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 798.34, "standard_charge_percentage": 70.0000, "estimated_amount": 798, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 912.38, "standard_charge_percentage": 80.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1026.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1026, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1026.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1026, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1117.67, "standard_charge_percentage": 98.0000, "estimated_amount": 1117, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 684.29, "standard_charge_percentage": 60.0000, "estimated_amount": 684, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 274.6, "estimated_amount": 274, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 195.05, "estimated_amount": 195, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 855.36, "standard_charge_percentage": 75.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1026.43, "standard_charge_percentage": 90.0000, "estimated_amount": 1026, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 969.41, "standard_charge_percentage": 85.0000, "estimated_amount": 969, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 997.92, "standard_charge_percentage": 87.5000, "estimated_amount": 997, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1140.48, "standard_charge_percentage": 100.0000, "estimated_amount": 1140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 912.38, "standard_charge_percentage": 80.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 207.8, "estimated_amount": 207, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 155.85, "estimated_amount": 155, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 237.49, "estimated_amount": 237, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 134.52, "estimated_amount": 134, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 570.24, "standard_charge_percentage": 50.0000, "estimated_amount": 570, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 912.38, "standard_charge_percentage": 80.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 997.92, "standard_charge_percentage": 87.5000, "estimated_amount": 997, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 912.38, "standard_charge_percentage": 80.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 912.38, "standard_charge_percentage": 80.0000, "estimated_amount": 912, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 342.14, "standard_charge_percentage": 30.0000, "estimated_amount": 342, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 798.34, "standard_charge_percentage": 70.0000, "estimated_amount": 798, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 798.34, "standard_charge_percentage": 70.0000, "estimated_amount": 798, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 638.67, "standard_charge_percentage": 56.0000, "estimated_amount": 638, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 421.98, "standard_charge_percentage": 37.0000, "estimated_amount": 421, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 855.36, "standard_charge_percentage": 75.0000, "estimated_amount": 855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 148.43, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 296.86, "estimated_amount": 296, "methodology": "fee schedule" }]}]} , { "description": "Sho Arthrs Srg Capsulorraphy", "code_information": [ { "code": "29806", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 11217.7, "discounted_cash": 8736,"minimum": 1123,"maximum": 11217.7,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 8708.56, "estimated_amount": 8708, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 10095.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10095, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 11217.7, "standard_charge_percentage": 100.0000, "estimated_amount": 11217, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 10656.8, "standard_charge_percentage": 95.0000, "estimated_amount": 10656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3365.31, "standard_charge_percentage": 30.0000, "estimated_amount": 3365, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 7852.39, "standard_charge_percentage": 70.0000, "estimated_amount": 7852, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 8413.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 8974.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8974, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 10095.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10095, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 10095.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10095, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 8413.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 9072.32, "estimated_amount": 9072, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 11217.7, "estimated_amount": 11217, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 10095.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10095, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 8974.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8974, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 8974.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8974, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 6730.62, "standard_charge_percentage": 60.0000, "estimated_amount": 6730, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 7852.39, "standard_charge_percentage": 70.0000, "estimated_amount": 7852, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 7852.39, "standard_charge_percentage": 70.0000, "estimated_amount": 7852, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 8769.46, "estimated_amount": 8769, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 8830.35, "estimated_amount": 8830, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 8413.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8413, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 8974.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8974, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 8413.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8413, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 8974.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8974, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 4487.08, "standard_charge_percentage": 40.0000, "estimated_amount": 4487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 9815.49, "standard_charge_percentage": 87.5000, "estimated_amount": 9815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 8974.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8974, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 8974.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 8413.27, "standard_charge_percentage": 75.0000, "estimated_amount": 8413, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 9198.51, "standard_charge_percentage": 82.0000, "estimated_amount": 9198, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 6281.91, "standard_charge_percentage": 56.0000, "estimated_amount": 6281, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 6506.27, "standard_charge_percentage": 58.0000, "estimated_amount": 6506, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 10993.4, "standard_charge_percentage": 98.0000, "estimated_amount": 10993, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 6730.62, "standard_charge_percentage": 60.0000, "estimated_amount": 6730, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 10752.4, "estimated_amount": 10752, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 5608.85, "standard_charge_percentage": 50.0000, "estimated_amount": 5608, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 10095.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10095, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 9535.05, "standard_charge_percentage": 85.0000, "estimated_amount": 9535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 9815.49, "standard_charge_percentage": 87.5000, "estimated_amount": 9815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 11217.7, "standard_charge_percentage": 100.0000, "estimated_amount": 11217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 8974.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8974, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 8974.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8974, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 8974.16, "standard_charge_percentage": 80.0000, "estimated_amount": 8974, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 9408.34, "estimated_amount": 9408, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 11217.7, "estimated_amount": 11217, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 11217.7, "estimated_amount": 11217, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29807", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7632.71, "discounted_cash": 8736,"minimum": 1123,"maximum": 7632.71,"payers_information":[{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6678.62, "standard_charge_percentage": 87.5000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6106.17, "standard_charge_percentage": 80.0000, "estimated_amount": 6106, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7632.71, "standard_charge_percentage": 100.0000, "estimated_amount": 7632, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7632.71, "standard_charge_percentage": 100.0000, "estimated_amount": 7632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6106.17, "standard_charge_percentage": 80.0000, "estimated_amount": 6106, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5342.9, "standard_charge_percentage": 70.0000, "estimated_amount": 5342, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7480.06, "standard_charge_percentage": 98.0000, "estimated_amount": 7480, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6869.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3053.08, "standard_charge_percentage": 40.0000, "estimated_amount": 3053, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6106.17, "standard_charge_percentage": 80.0000, "estimated_amount": 6106, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6106.17, "standard_charge_percentage": 80.0000, "estimated_amount": 6106, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5342.9, "standard_charge_percentage": 70.0000, "estimated_amount": 5342, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4274.32, "standard_charge_percentage": 56.0000, "estimated_amount": 4274, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6869.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6869.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4579.63, "standard_charge_percentage": 60.0000, "estimated_amount": 4579, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6854.64, "estimated_amount": 6854, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6631.81, "estimated_amount": 6631, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5724.53, "standard_charge_percentage": 75.0000, "estimated_amount": 5724, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6106.17, "standard_charge_percentage": 80.0000, "estimated_amount": 6106, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6106.17, "standard_charge_percentage": 80.0000, "estimated_amount": 6106, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6487.8, "standard_charge_percentage": 85.0000, "estimated_amount": 6487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6678.62, "standard_charge_percentage": 87.5000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6106.17, "standard_charge_percentage": 80.0000, "estimated_amount": 6106, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7251.07, "standard_charge_percentage": 95.0000, "estimated_amount": 7251, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4579.63, "standard_charge_percentage": 60.0000, "estimated_amount": 4579, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5724.53, "standard_charge_percentage": 75.0000, "estimated_amount": 5724, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5724.53, "standard_charge_percentage": 75.0000, "estimated_amount": 5724, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3816.36, "standard_charge_percentage": 50.0000, "estimated_amount": 3816, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6869.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6869.44, "standard_charge_percentage": 90.0000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6106.17, "standard_charge_percentage": 80.0000, "estimated_amount": 6106, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6106.17, "standard_charge_percentage": 80.0000, "estimated_amount": 6106, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2289.81, "standard_charge_percentage": 30.0000, "estimated_amount": 2289, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5342.9, "standard_charge_percentage": 70.0000, "estimated_amount": 5342, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5724.53, "standard_charge_percentage": 75.0000, "estimated_amount": 5724, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6258.82, "standard_charge_percentage": 82.0000, "estimated_amount": 6258, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4426.97, "standard_charge_percentage": 58.0000, "estimated_amount": 4426, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6106.17, "standard_charge_percentage": 80.0000, "estimated_amount": 6106, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5724.53, "standard_charge_percentage": 75.0000, "estimated_amount": 5724, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 7056.25, "estimated_amount": 7056, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6720.24, "estimated_amount": 6720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 7632.71, "estimated_amount": 7632, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29823", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6725.66, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 6725.66,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2690.26, "standard_charge_percentage": 40.0000, "estimated_amount": 2690, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5884.95, "standard_charge_percentage": 87.5000, "estimated_amount": 5884, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 6725.66, "standard_charge_percentage": 100.0000, "estimated_amount": 6725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5380.53, "standard_charge_percentage": 80.0000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4707.96, "standard_charge_percentage": 70.0000, "estimated_amount": 4707, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3766.37, "standard_charge_percentage": 56.0000, "estimated_amount": 3766, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5380.53, "standard_charge_percentage": 80.0000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6053.09, "standard_charge_percentage": 90.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5044.24, "standard_charge_percentage": 75.0000, "estimated_amount": 5044, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5380.53, "standard_charge_percentage": 80.0000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5044.24, "standard_charge_percentage": 75.0000, "estimated_amount": 5044, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5380.53, "standard_charge_percentage": 80.0000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 6389.38, "standard_charge_percentage": 95.0000, "estimated_amount": 6389, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4035.4, "standard_charge_percentage": 60.0000, "estimated_amount": 4035, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5380.53, "standard_charge_percentage": 80.0000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5380.53, "standard_charge_percentage": 80.0000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5044.24, "standard_charge_percentage": 75.0000, "estimated_amount": 5044, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6053.09, "standard_charge_percentage": 90.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5044.24, "standard_charge_percentage": 75.0000, "estimated_amount": 5044, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6053.09, "standard_charge_percentage": 90.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6053.09, "standard_charge_percentage": 90.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5716.81, "standard_charge_percentage": 85.0000, "estimated_amount": 5716, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5380.53, "standard_charge_percentage": 80.0000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5380.53, "standard_charge_percentage": 80.0000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2017.7, "standard_charge_percentage": 30.0000, "estimated_amount": 2017, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4707.96, "standard_charge_percentage": 70.0000, "estimated_amount": 4707, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 6591.15, "standard_charge_percentage": 98.0000, "estimated_amount": 6591, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5380.53, "standard_charge_percentage": 80.0000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3362.83, "standard_charge_percentage": 50.0000, "estimated_amount": 3362, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6053.09, "standard_charge_percentage": 90.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5884.95, "standard_charge_percentage": 87.5000, "estimated_amount": 5884, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5380.53, "standard_charge_percentage": 80.0000, "estimated_amount": 5380, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 6725.66, "standard_charge_percentage": 100.0000, "estimated_amount": 6725, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4707.96, "standard_charge_percentage": 70.0000, "estimated_amount": 4707, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5044.24, "standard_charge_percentage": 75.0000, "estimated_amount": 5044, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 5515.04, "standard_charge_percentage": 82.0000, "estimated_amount": 5515, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3900.88, "standard_charge_percentage": 58.0000, "estimated_amount": 3900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4035.4, "standard_charge_percentage": 60.0000, "estimated_amount": 4035, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6725.66, "estimated_amount": 6725, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29824", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2594.61, "discounted_cash": 3967,"minimum": 778.38,"maximum": 2594.61,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "case rate" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2075.69, "standard_charge_percentage": 80.0000, "estimated_amount": 2075, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2594.61, "standard_charge_percentage": 100.0000, "estimated_amount": 2594, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1556.77, "standard_charge_percentage": 60.0000, "estimated_amount": 1556, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1816.23, "standard_charge_percentage": 70.0000, "estimated_amount": 1816, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2127.58, "standard_charge_percentage": 82.0000, "estimated_amount": 2127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2075.69, "standard_charge_percentage": 80.0000, "estimated_amount": 2075, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1945.96, "standard_charge_percentage": 75.0000, "estimated_amount": 1945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1297.31, "standard_charge_percentage": 50.0000, "estimated_amount": 1297, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2335.15, "standard_charge_percentage": 90.0000, "estimated_amount": 2335, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2270.28, "standard_charge_percentage": 87.5000, "estimated_amount": 2270, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2464.88, "standard_charge_percentage": 95.0000, "estimated_amount": 2464, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2594.61, "standard_charge_percentage": 100.0000, "estimated_amount": 2594, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2075.69, "standard_charge_percentage": 80.0000, "estimated_amount": 2075, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2075.69, "standard_charge_percentage": 80.0000, "estimated_amount": 2075, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2075.69, "standard_charge_percentage": 80.0000, "estimated_amount": 2075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 778.38, "standard_charge_percentage": 30.0000, "estimated_amount": 778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1945.96, "standard_charge_percentage": 75.0000, "estimated_amount": 1945, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1945.96, "standard_charge_percentage": 75.0000, "estimated_amount": 1945, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1452.98, "standard_charge_percentage": 56.0000, "estimated_amount": 1452, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1504.87, "standard_charge_percentage": 58.0000, "estimated_amount": 1504, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2335.15, "standard_charge_percentage": 90.0000, "estimated_amount": 2335, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2542.72, "standard_charge_percentage": 98.0000, "estimated_amount": 2542, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1627, "estimated_amount": 1627, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2335.15, "standard_charge_percentage": 90.0000, "estimated_amount": 2335, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2335.15, "standard_charge_percentage": 90.0000, "estimated_amount": 2335, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2270.28, "standard_charge_percentage": 87.5000, "estimated_amount": 2270, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2075.69, "standard_charge_percentage": 80.0000, "estimated_amount": 2075, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2075.69, "standard_charge_percentage": 80.0000, "estimated_amount": 2075, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2075.69, "standard_charge_percentage": 80.0000, "estimated_amount": 2075, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1945.96, "standard_charge_percentage": 75.0000, "estimated_amount": 1945, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1945.96, "standard_charge_percentage": 75.0000, "estimated_amount": 1945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2075.69, "standard_charge_percentage": 80.0000, "estimated_amount": 2075, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2205.42, "standard_charge_percentage": 85.0000, "estimated_amount": 2205, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1037.84, "standard_charge_percentage": 40.0000, "estimated_amount": 1037, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2075.69, "standard_charge_percentage": 80.0000, "estimated_amount": 2075, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1816.23, "standard_charge_percentage": 70.0000, "estimated_amount": 1816, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1816.23, "standard_charge_percentage": 70.0000, "estimated_amount": 1816, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2335.15, "standard_charge_percentage": 90.0000, "estimated_amount": 2335, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1556.77, "standard_charge_percentage": 60.0000, "estimated_amount": 1556, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2594.61, "estimated_amount": 2594, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29826", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2853.85,"minimum": 780,"maximum": 2853.85,"payers_information":[{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2283.08, "standard_charge_percentage": 80.0000, "estimated_amount": 2283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1426.92, "standard_charge_percentage": 50.0000, "estimated_amount": 1426, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2853.85, "standard_charge_percentage": 100.0000, "estimated_amount": 2853, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2283.08, "standard_charge_percentage": 80.0000, "estimated_amount": 2283, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1997.69, "standard_charge_percentage": 70.0000, "estimated_amount": 1997, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2140.39, "standard_charge_percentage": 75.0000, "estimated_amount": 2140, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2340.16, "standard_charge_percentage": 82.0000, "estimated_amount": 2340, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2853.85, "estimated_amount": 2853, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2140.39, "standard_charge_percentage": 75.0000, "estimated_amount": 2140, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2283.08, "standard_charge_percentage": 80.0000, "estimated_amount": 2283, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2140.39, "standard_charge_percentage": 75.0000, "estimated_amount": 2140, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2568.47, "standard_charge_percentage": 90.0000, "estimated_amount": 2568, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2568.47, "standard_charge_percentage": 90.0000, "estimated_amount": 2568, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1141.54, "standard_charge_percentage": 40.0000, "estimated_amount": 1141, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2853.85, "standard_charge_percentage": 100.0000, "estimated_amount": 2853, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2283.08, "standard_charge_percentage": 80.0000, "estimated_amount": 2283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 856.15, "standard_charge_percentage": 30.0000, "estimated_amount": 856, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2568.47, "standard_charge_percentage": 90.0000, "estimated_amount": 2568, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2140.39, "standard_charge_percentage": 75.0000, "estimated_amount": 2140, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 780, "estimated_amount": 780, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2568.47, "standard_charge_percentage": 90.0000, "estimated_amount": 2568, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2497.12, "standard_charge_percentage": 87.5000, "estimated_amount": 2497, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2283.08, "standard_charge_percentage": 80.0000, "estimated_amount": 2283, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1997.69, "standard_charge_percentage": 70.0000, "estimated_amount": 1997, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1655.23, "standard_charge_percentage": 58.0000, "estimated_amount": 1655, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2796.77, "standard_charge_percentage": 98.0000, "estimated_amount": 2796, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2425.77, "standard_charge_percentage": 85.0000, "estimated_amount": 2425, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2497.12, "standard_charge_percentage": 87.5000, "estimated_amount": 2497, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2283.08, "standard_charge_percentage": 80.0000, "estimated_amount": 2283, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2283.08, "standard_charge_percentage": 80.0000, "estimated_amount": 2283, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2711.16, "standard_charge_percentage": 95.0000, "estimated_amount": 2711, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1712.31, "standard_charge_percentage": 60.0000, "estimated_amount": 1712, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2283.08, "standard_charge_percentage": 80.0000, "estimated_amount": 2283, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2283.08, "standard_charge_percentage": 80.0000, "estimated_amount": 2283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2140.39, "standard_charge_percentage": 75.0000, "estimated_amount": 2140, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1997.69, "standard_charge_percentage": 70.0000, "estimated_amount": 1997, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1598.16, "standard_charge_percentage": 56.0000, "estimated_amount": 1598, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2283.08, "standard_charge_percentage": 80.0000, "estimated_amount": 2283, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2568.47, "standard_charge_percentage": 90.0000, "estimated_amount": 2568, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1712.31, "standard_charge_percentage": 60.0000, "estimated_amount": 1712, "methodology": "percent of total billed charges" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29827", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2708.94, "discounted_cash": 8736,"minimum": 812.68,"maximum": 2708.94,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1627, "estimated_amount": 1627, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2167.15, "standard_charge_percentage": 80.0000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2438.05, "standard_charge_percentage": 90.0000, "estimated_amount": 2438, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2167.15, "standard_charge_percentage": 80.0000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2708.94, "standard_charge_percentage": 100.0000, "estimated_amount": 2708, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2167.15, "standard_charge_percentage": 80.0000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 812.68, "standard_charge_percentage": 30.0000, "estimated_amount": 812, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1896.26, "standard_charge_percentage": 70.0000, "estimated_amount": 1896, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1517.01, "standard_charge_percentage": 56.0000, "estimated_amount": 1517, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2438.05, "standard_charge_percentage": 90.0000, "estimated_amount": 2438, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2302.6, "standard_charge_percentage": 85.0000, "estimated_amount": 2302, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2370.32, "standard_charge_percentage": 87.5000, "estimated_amount": 2370, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2370.32, "standard_charge_percentage": 87.5000, "estimated_amount": 2370, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1625.36, "standard_charge_percentage": 60.0000, "estimated_amount": 1625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2167.15, "standard_charge_percentage": 80.0000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2031.7, "standard_charge_percentage": 75.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1896.26, "standard_charge_percentage": 70.0000, "estimated_amount": 1896, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2221.33, "standard_charge_percentage": 82.0000, "estimated_amount": 2221, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1571.19, "standard_charge_percentage": 58.0000, "estimated_amount": 1571, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2438.05, "standard_charge_percentage": 90.0000, "estimated_amount": 2438, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2654.76, "standard_charge_percentage": 98.0000, "estimated_amount": 2654, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1625.36, "standard_charge_percentage": 60.0000, "estimated_amount": 1625, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2031.7, "standard_charge_percentage": 75.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2031.7, "standard_charge_percentage": 75.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2438.05, "standard_charge_percentage": 90.0000, "estimated_amount": 2438, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2438.05, "standard_charge_percentage": 90.0000, "estimated_amount": 2438, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1083.58, "standard_charge_percentage": 40.0000, "estimated_amount": 1083, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2167.15, "standard_charge_percentage": 80.0000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2708.94, "standard_charge_percentage": 100.0000, "estimated_amount": 2708, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2167.15, "standard_charge_percentage": 80.0000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2167.15, "standard_charge_percentage": 80.0000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2031.7, "standard_charge_percentage": 75.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2167.15, "standard_charge_percentage": 80.0000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2167.15, "standard_charge_percentage": 80.0000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1354.47, "standard_charge_percentage": 50.0000, "estimated_amount": 1354, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2167.15, "standard_charge_percentage": 80.0000, "estimated_amount": 2167, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2573.49, "standard_charge_percentage": 95.0000, "estimated_amount": 2573, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1896.26, "standard_charge_percentage": 70.0000, "estimated_amount": 1896, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2031.7, "standard_charge_percentage": 75.0000, "estimated_amount": 2031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2708.94, "estimated_amount": 2708, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29828", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2610.85, "discounted_cash": 8736,"minimum": 783.25,"maximum": 2610.85,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1958.14, "standard_charge_percentage": 75.0000, "estimated_amount": 1958, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1958.14, "standard_charge_percentage": 75.0000, "estimated_amount": 1958, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2088.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2088, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2219.22, "standard_charge_percentage": 85.0000, "estimated_amount": 2219, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2088.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2088, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2088.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2088, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2610.85, "standard_charge_percentage": 100.0000, "estimated_amount": 2610, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2140.9, "standard_charge_percentage": 82.0000, "estimated_amount": 2140, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 966.01, "standard_charge_percentage": 37.0000, "estimated_amount": 966, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2349.76, "standard_charge_percentage": 90.0000, "estimated_amount": 2349, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1958.14, "standard_charge_percentage": 75.0000, "estimated_amount": 1958, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1566.51, "standard_charge_percentage": 60.0000, "estimated_amount": 1566, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2088.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2088, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2349.76, "standard_charge_percentage": 90.0000, "estimated_amount": 2349, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2349.76, "standard_charge_percentage": 90.0000, "estimated_amount": 2349, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2349.76, "standard_charge_percentage": 90.0000, "estimated_amount": 2349, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2284.49, "standard_charge_percentage": 87.5000, "estimated_amount": 2284, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2284.49, "standard_charge_percentage": 87.5000, "estimated_amount": 2284, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2480.31, "standard_charge_percentage": 95.0000, "estimated_amount": 2480, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1566.51, "standard_charge_percentage": 60.0000, "estimated_amount": 1566, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1827.6, "standard_charge_percentage": 70.0000, "estimated_amount": 1827, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1958.14, "standard_charge_percentage": 75.0000, "estimated_amount": 1958, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1462.08, "standard_charge_percentage": 56.0000, "estimated_amount": 1462, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2349.76, "standard_charge_percentage": 90.0000, "estimated_amount": 2349, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2088.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2088, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2088.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2088, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2088.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1958.14, "standard_charge_percentage": 75.0000, "estimated_amount": 1958, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1514.29, "standard_charge_percentage": 58.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1305.42, "standard_charge_percentage": 50.0000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1044.34, "standard_charge_percentage": 40.0000, "estimated_amount": 1044, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2088.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2088, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2610.85, "standard_charge_percentage": 100.0000, "estimated_amount": 2610, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2088.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 783.25, "standard_charge_percentage": 30.0000, "estimated_amount": 783, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1827.6, "standard_charge_percentage": 70.0000, "estimated_amount": 1827, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1827.6, "standard_charge_percentage": 70.0000, "estimated_amount": 1827, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2088.68, "standard_charge_percentage": 80.0000, "estimated_amount": 2088, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2558.63, "standard_charge_percentage": 98.0000, "estimated_amount": 2558, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2610.85, "estimated_amount": 2610, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29873", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7933.93, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 7933.93,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5950.45, "standard_charge_percentage": 75.0000, "estimated_amount": 5950, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6347.14, "standard_charge_percentage": 80.0000, "estimated_amount": 6347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3966.97, "standard_charge_percentage": 50.0000, "estimated_amount": 3966, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6743.84, "standard_charge_percentage": 85.0000, "estimated_amount": 6743, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6942.19, "standard_charge_percentage": 87.5000, "estimated_amount": 6942, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5553.75, "standard_charge_percentage": 70.0000, "estimated_amount": 5553, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6347.14, "standard_charge_percentage": 80.0000, "estimated_amount": 6347, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7140.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7140, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 7933.93, "estimated_amount": 7933, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7140.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7140, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7140.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7140, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6942.19, "standard_charge_percentage": 87.5000, "estimated_amount": 6942, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6347.14, "standard_charge_percentage": 80.0000, "estimated_amount": 6347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5950.45, "standard_charge_percentage": 75.0000, "estimated_amount": 5950, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5553.75, "standard_charge_percentage": 70.0000, "estimated_amount": 5553, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4443, "standard_charge_percentage": 56.0000, "estimated_amount": 4443, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4601.68, "standard_charge_percentage": 58.0000, "estimated_amount": 4601, "methodology": "percent of total billed charges" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5950.45, "standard_charge_percentage": 75.0000, "estimated_amount": 5950, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6347.14, "standard_charge_percentage": 80.0000, "estimated_amount": 6347, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6347.14, "standard_charge_percentage": 80.0000, "estimated_amount": 6347, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6347.14, "standard_charge_percentage": 80.0000, "estimated_amount": 6347, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7537.23, "standard_charge_percentage": 95.0000, "estimated_amount": 7537, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4760.36, "standard_charge_percentage": 60.0000, "estimated_amount": 4760, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6347.14, "standard_charge_percentage": 80.0000, "estimated_amount": 6347, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6505.82, "standard_charge_percentage": 82.0000, "estimated_amount": 6505, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7140.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7140, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5950.45, "standard_charge_percentage": 75.0000, "estimated_amount": 5950, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7140.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7140, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3173.57, "standard_charge_percentage": 40.0000, "estimated_amount": 3173, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6347.14, "standard_charge_percentage": 80.0000, "estimated_amount": 6347, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7933.93, "standard_charge_percentage": 100.0000, "estimated_amount": 7933, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7933.93, "standard_charge_percentage": 100.0000, "estimated_amount": 7933, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6347.14, "standard_charge_percentage": 80.0000, "estimated_amount": 6347, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6347.14, "standard_charge_percentage": 80.0000, "estimated_amount": 6347, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2380.18, "standard_charge_percentage": 30.0000, "estimated_amount": 2380, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5553.75, "standard_charge_percentage": 70.0000, "estimated_amount": 5553, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5950.45, "standard_charge_percentage": 75.0000, "estimated_amount": 5950, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7775.25, "standard_charge_percentage": 98.0000, "estimated_amount": 7775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4760.36, "standard_charge_percentage": 60.0000, "estimated_amount": 4760, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29879", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6516.58, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 6516.58,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 6516.58, "standard_charge_percentage": 100.0000, "estimated_amount": 6516, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3909.95, "standard_charge_percentage": 60.0000, "estimated_amount": 3909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1954.97, "standard_charge_percentage": 30.0000, "estimated_amount": 1954, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4887.44, "standard_charge_percentage": 75.0000, "estimated_amount": 4887, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5864.92, "standard_charge_percentage": 90.0000, "estimated_amount": 5864, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4887.44, "standard_charge_percentage": 75.0000, "estimated_amount": 4887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3258.29, "standard_charge_percentage": 50.0000, "estimated_amount": 3258, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5864.92, "standard_charge_percentage": 90.0000, "estimated_amount": 5864, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5539.09, "standard_charge_percentage": 85.0000, "estimated_amount": 5539, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5702.01, "standard_charge_percentage": 87.5000, "estimated_amount": 5702, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5702.01, "standard_charge_percentage": 87.5000, "estimated_amount": 5702, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 6190.75, "standard_charge_percentage": 95.0000, "estimated_amount": 6190, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5213.26, "standard_charge_percentage": 80.0000, "estimated_amount": 5213, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5213.26, "standard_charge_percentage": 80.0000, "estimated_amount": 5213, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5213.26, "standard_charge_percentage": 80.0000, "estimated_amount": 5213, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5213.26, "standard_charge_percentage": 80.0000, "estimated_amount": 5213, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4887.44, "standard_charge_percentage": 75.0000, "estimated_amount": 4887, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3779.62, "standard_charge_percentage": 58.0000, "estimated_amount": 3779, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5213.26, "standard_charge_percentage": 80.0000, "estimated_amount": 5213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3909.95, "standard_charge_percentage": 60.0000, "estimated_amount": 3909, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6516.58, "estimated_amount": 6516, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5213.26, "standard_charge_percentage": 80.0000, "estimated_amount": 5213, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5213.26, "standard_charge_percentage": 80.0000, "estimated_amount": 5213, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5864.92, "standard_charge_percentage": 90.0000, "estimated_amount": 5864, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5213.26, "standard_charge_percentage": 80.0000, "estimated_amount": 5213, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5213.26, "standard_charge_percentage": 80.0000, "estimated_amount": 5213, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4561.61, "standard_charge_percentage": 70.0000, "estimated_amount": 4561, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 5343.6, "standard_charge_percentage": 82.0000, "estimated_amount": 5343, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 6386.25, "standard_charge_percentage": 98.0000, "estimated_amount": 6386, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4887.44, "standard_charge_percentage": 75.0000, "estimated_amount": 4887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4887.44, "standard_charge_percentage": 75.0000, "estimated_amount": 4887, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5864.92, "standard_charge_percentage": 90.0000, "estimated_amount": 5864, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2606.63, "standard_charge_percentage": 40.0000, "estimated_amount": 2606, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5213.26, "standard_charge_percentage": 80.0000, "estimated_amount": 5213, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 6516.58, "standard_charge_percentage": 100.0000, "estimated_amount": 6516, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4561.61, "standard_charge_percentage": 70.0000, "estimated_amount": 4561, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4561.61, "standard_charge_percentage": 70.0000, "estimated_amount": 4561, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3649.28, "standard_charge_percentage": 56.0000, "estimated_amount": 3649, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5864.92, "standard_charge_percentage": 90.0000, "estimated_amount": 5864, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29881", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4657.31, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 4657.31,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3492.98, "standard_charge_percentage": 75.0000, "estimated_amount": 3492, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 4191.58, "standard_charge_percentage": 90.0000, "estimated_amount": 4191, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3725.85, "standard_charge_percentage": 80.0000, "estimated_amount": 3725, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3725.85, "standard_charge_percentage": 80.0000, "estimated_amount": 3725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1397.19, "standard_charge_percentage": 30.0000, "estimated_amount": 1397, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3260.12, "standard_charge_percentage": 70.0000, "estimated_amount": 3260, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2701.24, "standard_charge_percentage": 58.0000, "estimated_amount": 2701, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3492.98, "standard_charge_percentage": 75.0000, "estimated_amount": 3492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2794.39, "standard_charge_percentage": 60.0000, "estimated_amount": 2794, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4657.31, "estimated_amount": 4657, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3725.85, "standard_charge_percentage": 80.0000, "estimated_amount": 3725, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3492.98, "standard_charge_percentage": 75.0000, "estimated_amount": 3492, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3818.99, "standard_charge_percentage": 82.0000, "estimated_amount": 3818, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2608.09, "standard_charge_percentage": 56.0000, "estimated_amount": 2608, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3725.85, "standard_charge_percentage": 80.0000, "estimated_amount": 3725, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 4191.58, "standard_charge_percentage": 90.0000, "estimated_amount": 4191, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 4657.31, "estimated_amount": 4657, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2328.66, "standard_charge_percentage": 50.0000, "estimated_amount": 2328, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 4191.58, "standard_charge_percentage": 90.0000, "estimated_amount": 4191, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3958.71, "standard_charge_percentage": 85.0000, "estimated_amount": 3958, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 4657.31, "standard_charge_percentage": 100.0000, "estimated_amount": 4657, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 4424.44, "standard_charge_percentage": 95.0000, "estimated_amount": 4424, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 4657.31, "standard_charge_percentage": 100.0000, "estimated_amount": 4657, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2794.39, "standard_charge_percentage": 60.0000, "estimated_amount": 2794, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3725.85, "standard_charge_percentage": 80.0000, "estimated_amount": 3725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3492.98, "standard_charge_percentage": 75.0000, "estimated_amount": 3492, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 4564.16, "standard_charge_percentage": 98.0000, "estimated_amount": 4564, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4657.31, "estimated_amount": 4657, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1403, "estimated_amount": 1403, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3725.85, "standard_charge_percentage": 80.0000, "estimated_amount": 3725, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3492.98, "standard_charge_percentage": 75.0000, "estimated_amount": 3492, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 4191.58, "standard_charge_percentage": 90.0000, "estimated_amount": 4191, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1862.92, "standard_charge_percentage": 40.0000, "estimated_amount": 1862, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 4075.15, "standard_charge_percentage": 87.5000, "estimated_amount": 4075, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 4075.15, "standard_charge_percentage": 87.5000, "estimated_amount": 4075, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3725.85, "standard_charge_percentage": 80.0000, "estimated_amount": 3725, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3725.85, "standard_charge_percentage": 80.0000, "estimated_amount": 3725, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3725.85, "standard_charge_percentage": 80.0000, "estimated_amount": 3725, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3725.85, "standard_charge_percentage": 80.0000, "estimated_amount": 3725, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3260.12, "standard_charge_percentage": 70.0000, "estimated_amount": 3260, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3260.12, "standard_charge_percentage": 70.0000, "estimated_amount": 3260, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 4191.58, "standard_charge_percentage": 90.0000, "estimated_amount": 4191, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 4657.31, "estimated_amount": 4657, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4657.31, "estimated_amount": 4657, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29882", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6453.27, "discounted_cash": 3967,"minimum": 1048.57,"maximum": 6453.27,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3983, "estimated_amount": 3983, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1048.57, "estimated_amount": 1048, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 6130.61, "standard_charge_percentage": 95.0000, "estimated_amount": 6130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 5291.68, "standard_charge_percentage": 82.0000, "estimated_amount": 5291, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2984.4, "estimated_amount": 2984, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3955.34, "estimated_amount": 3955, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3226.64, "standard_charge_percentage": 50.0000, "estimated_amount": 3226, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5485.28, "standard_charge_percentage": 85.0000, "estimated_amount": 5485, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2581.31, "standard_charge_percentage": 40.0000, "estimated_amount": 2581, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5646.61, "standard_charge_percentage": 87.5000, "estimated_amount": 5646, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3871.96, "standard_charge_percentage": 60.0000, "estimated_amount": 3871, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4517.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4517.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4273.16, "estimated_amount": 4273, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3204.87, "estimated_amount": 3204, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5646.68, "estimated_amount": 5646, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2765.97, "estimated_amount": 2765, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 6453.27, "standard_charge_percentage": 100.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 6453.27, "standard_charge_percentage": 100.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1935.98, "standard_charge_percentage": 30.0000, "estimated_amount": 1935, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4517.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 6324.2, "standard_charge_percentage": 98.0000, "estimated_amount": 6324, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3113.31, "estimated_amount": 3113, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4883.62, "estimated_amount": 4883, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6104.52, "estimated_amount": 6104, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4010.66, "estimated_amount": 4010, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5646.61, "standard_charge_percentage": 87.5000, "estimated_amount": 5646, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3613.83, "standard_charge_percentage": 56.0000, "estimated_amount": 3613, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3742.9, "standard_charge_percentage": 58.0000, "estimated_amount": 3742, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3871.96, "standard_charge_percentage": 60.0000, "estimated_amount": 3871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4120.55, "estimated_amount": 4120, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3052.26, "estimated_amount": 3052, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29888", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6453.27, "discounted_cash": 8736,"minimum": 1123,"maximum": 6453.27,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3226.64, "standard_charge_percentage": 50.0000, "estimated_amount": 3226, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5485.28, "standard_charge_percentage": 85.0000, "estimated_amount": 5485, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2581.31, "standard_charge_percentage": 40.0000, "estimated_amount": 2581, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3871.96, "standard_charge_percentage": 60.0000, "estimated_amount": 3871, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4517.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4517.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 6324.2, "standard_charge_percentage": 98.0000, "estimated_amount": 6324, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 6453.27, "standard_charge_percentage": 100.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 6453.27, "standard_charge_percentage": 100.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1935.98, "standard_charge_percentage": 30.0000, "estimated_amount": 1935, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4517.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 5291.68, "standard_charge_percentage": 82.0000, "estimated_amount": 5291, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2317.55, "estimated_amount": 2317, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5646.61, "standard_charge_percentage": 87.5000, "estimated_amount": 5646, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 6130.61, "standard_charge_percentage": 95.0000, "estimated_amount": 6130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6089.9, "estimated_amount": 6089, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5646.61, "standard_charge_percentage": 87.5000, "estimated_amount": 5646, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3613.83, "standard_charge_percentage": 56.0000, "estimated_amount": 3613, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3742.9, "standard_charge_percentage": 58.0000, "estimated_amount": 3742, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3871.96, "standard_charge_percentage": 60.0000, "estimated_amount": 3871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "29889", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6453.27, "discounted_cash": 15735,"minimum": 1123,"maximum": 6453.27,"payers_information":[{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3226.64, "standard_charge_percentage": 50.0000, "estimated_amount": 3226, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5646.61, "standard_charge_percentage": 87.5000, "estimated_amount": 5646, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5646.61, "standard_charge_percentage": 87.5000, "estimated_amount": 5646, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3871.96, "standard_charge_percentage": 60.0000, "estimated_amount": 3871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3742.9, "standard_charge_percentage": 58.0000, "estimated_amount": 3742, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3871.96, "standard_charge_percentage": 60.0000, "estimated_amount": 3871, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 6453.27, "standard_charge_percentage": 100.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1935.98, "standard_charge_percentage": 30.0000, "estimated_amount": 1935, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 5291.68, "standard_charge_percentage": 82.0000, "estimated_amount": 5291, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3613.83, "standard_charge_percentage": 56.0000, "estimated_amount": 3613, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2581.31, "standard_charge_percentage": 40.0000, "estimated_amount": 2581, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 6453.27, "standard_charge_percentage": 100.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 6130.61, "standard_charge_percentage": 95.0000, "estimated_amount": 6130, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4517.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5807.94, "standard_charge_percentage": 90.0000, "estimated_amount": 5807, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 6324.2, "standard_charge_percentage": 98.0000, "estimated_amount": 6324, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4263.54, "estimated_amount": 4263, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4839.95, "standard_charge_percentage": 75.0000, "estimated_amount": 4839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5485.28, "standard_charge_percentage": 85.0000, "estimated_amount": 5485, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4517.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4517.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5162.62, "standard_charge_percentage": 80.0000, "estimated_amount": 5162, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 6453.27, "estimated_amount": 6453, "methodology": "fee schedule" }]}]} , { "description": "Hc Remove Nasal Fb", "code_information": [ { "code": "30300", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 629.19, "discounted_cash": 157,"minimum": 109.89,"maximum": 629.19,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 352.35, "standard_charge_percentage": 56.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 251.68, "standard_charge_percentage": 40.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 597.73, "standard_charge_percentage": 95.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 188.76, "standard_charge_percentage": 30.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 364.93, "standard_charge_percentage": 58.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 534.81, "standard_charge_percentage": 85.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 140.4, "estimated_amount": 140, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 515.94, "standard_charge_percentage": 82.0000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 232.8, "standard_charge_percentage": 37.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 616.61, "standard_charge_percentage": 98.0000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" }]}]} , { "description": "Hc Control Nose Bleed Anter Simple", "code_information": [ { "code": "30901", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 629.19, "discounted_cash": 157,"minimum": 109.89,"maximum": 629.19,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 234, "estimated_amount": 234, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 629.19, "estimated_amount": 629, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 188.76, "standard_charge_percentage": 30.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 364.93, "standard_charge_percentage": 58.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 534.81, "standard_charge_percentage": 85.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 251.68, "standard_charge_percentage": 40.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 597.73, "standard_charge_percentage": 95.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 515.94, "standard_charge_percentage": 82.0000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 352.35, "standard_charge_percentage": 56.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 232.8, "standard_charge_percentage": 37.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 616.61, "standard_charge_percentage": 98.0000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" }]}]} , { "description": "Hc Control Nose Bleed Anter Complex", "code_information": [ { "code": "30903", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 629.19, "discounted_cash": 157,"minimum": 109.89,"maximum": 629.19,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 597.73, "standard_charge_percentage": 95.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 312, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 629.19, "estimated_amount": 629, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 188.76, "standard_charge_percentage": 30.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 364.93, "standard_charge_percentage": 58.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 534.81, "standard_charge_percentage": 85.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 251.68, "standard_charge_percentage": 40.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 515.94, "standard_charge_percentage": 82.0000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 352.35, "standard_charge_percentage": 56.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 232.8, "standard_charge_percentage": 37.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 616.61, "standard_charge_percentage": 98.0000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" }]}]} , { "description": "Hc Control Nose Bleed Post Pack/Caut Init", "code_information": [ { "code": "30905", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 629.19, "discounted_cash": 157,"minimum": 109.89,"maximum": 629.19,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 286, "estimated_amount": 286, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 629.19, "estimated_amount": 629, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 314.6, "standard_charge_percentage": 50.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 550.54, "standard_charge_percentage": 87.5000, "estimated_amount": 550, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 352.35, "standard_charge_percentage": 56.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 616.61, "standard_charge_percentage": 98.0000, "estimated_amount": 616, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 251.68, "standard_charge_percentage": 40.0000, "estimated_amount": 251, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 597.73, "standard_charge_percentage": 95.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 188.76, "standard_charge_percentage": 30.0000, "estimated_amount": 188, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 440.43, "standard_charge_percentage": 70.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 364.93, "standard_charge_percentage": 58.0000, "estimated_amount": 364, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 232.8, "standard_charge_percentage": 37.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 534.81, "standard_charge_percentage": 85.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 629.19, "standard_charge_percentage": 100.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 471.89, "standard_charge_percentage": 75.0000, "estimated_amount": 471, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 503.35, "standard_charge_percentage": 80.0000, "estimated_amount": 503, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 377.51, "standard_charge_percentage": 60.0000, "estimated_amount": 377, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 515.94, "standard_charge_percentage": 82.0000, "estimated_amount": 515, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 566.27, "standard_charge_percentage": 90.0000, "estimated_amount": 566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" }]}]} , { "description": "Hc Repeat Control Of Nosebleed", "code_information": [ { "code": "30906", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1102.43, "discounted_cash": 283,"minimum": 197.97,"maximum": 1102.43,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 197.97, "estimated_amount": 197, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 826.82, "standard_charge_percentage": 75.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 551.22, "standard_charge_percentage": 50.0000, "estimated_amount": 551, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 992.19, "standard_charge_percentage": 90.0000, "estimated_amount": 992, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 440.97, "standard_charge_percentage": 40.0000, "estimated_amount": 440, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 964.63, "standard_charge_percentage": 87.5000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 881.94, "standard_charge_percentage": 80.0000, "estimated_amount": 881, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 881.94, "standard_charge_percentage": 80.0000, "estimated_amount": 881, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 881.94, "standard_charge_percentage": 80.0000, "estimated_amount": 881, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 771.7, "standard_charge_percentage": 70.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 826.82, "standard_charge_percentage": 75.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 639.41, "standard_charge_percentage": 58.0000, "estimated_amount": 639, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 881.94, "standard_charge_percentage": 80.0000, "estimated_amount": 881, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1080.38, "standard_charge_percentage": 98.0000, "estimated_amount": 1080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 661.46, "standard_charge_percentage": 60.0000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 229.37, "estimated_amount": 229, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 305.83, "estimated_amount": 305, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 287.06, "estimated_amount": 287, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 283.1, "estimated_amount": 283, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1102.43, "estimated_amount": 1102, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 826.82, "standard_charge_percentage": 75.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 881.94, "standard_charge_percentage": 80.0000, "estimated_amount": 881, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 881.94, "standard_charge_percentage": 80.0000, "estimated_amount": 881, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1047.31, "standard_charge_percentage": 95.0000, "estimated_amount": 1047, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1102.43, "standard_charge_percentage": 100.0000, "estimated_amount": 1102, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 661.46, "standard_charge_percentage": 60.0000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 881.94, "standard_charge_percentage": 80.0000, "estimated_amount": 881, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 826.82, "standard_charge_percentage": 75.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 903.99, "standard_charge_percentage": 82.0000, "estimated_amount": 903, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 305.83, "estimated_amount": 305, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 222.82, "estimated_amount": 222, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 229.37, "estimated_amount": 229, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 285.08, "estimated_amount": 285, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 208.37, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 992.19, "standard_charge_percentage": 90.0000, "estimated_amount": 992, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 964.63, "standard_charge_percentage": 87.5000, "estimated_amount": 964, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1102.43, "standard_charge_percentage": 100.0000, "estimated_amount": 1102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 881.94, "standard_charge_percentage": 80.0000, "estimated_amount": 881, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 881.94, "standard_charge_percentage": 80.0000, "estimated_amount": 881, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 330.73, "standard_charge_percentage": 30.0000, "estimated_amount": 330, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 771.7, "standard_charge_percentage": 70.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 617.36, "standard_charge_percentage": 56.0000, "estimated_amount": 617, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 407.9, "standard_charge_percentage": 37.0000, "estimated_amount": 407, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 992.19, "standard_charge_percentage": 90.0000, "estimated_amount": 992, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 826.82, "standard_charge_percentage": 75.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 349.52, "estimated_amount": 349, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 436.9, "estimated_amount": 436, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 197.97, "estimated_amount": 197, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 992.19, "standard_charge_percentage": 90.0000, "estimated_amount": 992, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 937.07, "standard_charge_percentage": 85.0000, "estimated_amount": 937, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 881.94, "standard_charge_percentage": 80.0000, "estimated_amount": 881, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 771.7, "standard_charge_percentage": 70.0000, "estimated_amount": 771, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 992.19, "standard_charge_percentage": 90.0000, "estimated_amount": 992, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 773.5, "estimated_amount": 773, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 294.91, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 404.13, "estimated_amount": 404, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 349.52, "estimated_amount": 349, "methodology": "fee schedule" }]}]} , { "description": "Hc Intubation Endotracheal", "code_information": [ { "code": "31500", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1180.52, "discounted_cash": 283,"minimum": 197.97,"maximum": 1180.52,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 285.08, "estimated_amount": 285, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 208.37, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 944.42, "standard_charge_percentage": 80.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 944.42, "standard_charge_percentage": 80.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1180.52, "standard_charge_percentage": 100.0000, "estimated_amount": 1180, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 944.42, "standard_charge_percentage": 80.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 944.42, "standard_charge_percentage": 80.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 354.16, "standard_charge_percentage": 30.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 885.39, "standard_charge_percentage": 75.0000, "estimated_amount": 885, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 826.36, "standard_charge_percentage": 70.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 885.39, "standard_charge_percentage": 75.0000, "estimated_amount": 885, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 968.03, "standard_charge_percentage": 82.0000, "estimated_amount": 968, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 944.42, "standard_charge_percentage": 80.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1156.91, "standard_charge_percentage": 98.0000, "estimated_amount": 1156, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 773.5, "estimated_amount": 773, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 294.91, "estimated_amount": 294, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 305.83, "estimated_amount": 305, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 349.52, "estimated_amount": 349, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 436.9, "estimated_amount": 436, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 287.06, "estimated_amount": 287, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 283.1, "estimated_amount": 283, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1032.95, "standard_charge_percentage": 87.5000, "estimated_amount": 1032, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1032.95, "standard_charge_percentage": 87.5000, "estimated_amount": 1032, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 708.31, "standard_charge_percentage": 60.0000, "estimated_amount": 708, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 404.13, "estimated_amount": 404, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 197.97, "estimated_amount": 197, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 197.97, "estimated_amount": 197, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1180.52, "estimated_amount": 1180, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 885.39, "standard_charge_percentage": 75.0000, "estimated_amount": 885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 944.42, "standard_charge_percentage": 80.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 590.26, "standard_charge_percentage": 50.0000, "estimated_amount": 590, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1062.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1062, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1003.44, "standard_charge_percentage": 85.0000, "estimated_amount": 1003, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 944.42, "standard_charge_percentage": 80.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 684.7, "standard_charge_percentage": 58.0000, "estimated_amount": 684, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 436.79, "standard_charge_percentage": 37.0000, "estimated_amount": 436, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1062.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1062, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 885.39, "standard_charge_percentage": 75.0000, "estimated_amount": 885, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 229.37, "estimated_amount": 229, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 234, "estimated_amount": 234, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 885.39, "standard_charge_percentage": 75.0000, "estimated_amount": 885, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1062.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1062, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1062.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1062, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 472.21, "standard_charge_percentage": 40.0000, "estimated_amount": 472, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 944.42, "standard_charge_percentage": 80.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 944.42, "standard_charge_percentage": 80.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1121.49, "standard_charge_percentage": 95.0000, "estimated_amount": 1121, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1180.52, "standard_charge_percentage": 100.0000, "estimated_amount": 1180, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 708.31, "standard_charge_percentage": 60.0000, "estimated_amount": 708, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 944.42, "standard_charge_percentage": 80.0000, "estimated_amount": 944, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 826.36, "standard_charge_percentage": 70.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 826.36, "standard_charge_percentage": 70.0000, "estimated_amount": 826, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 661.09, "standard_charge_percentage": 56.0000, "estimated_amount": 661, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1062.47, "standard_charge_percentage": 90.0000, "estimated_amount": 1062, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 305.83, "estimated_amount": 305, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 229.37, "estimated_amount": 229, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 222.82, "estimated_amount": 222, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 349.52, "estimated_amount": 349, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 218.45, "estimated_amount": 218, "methodology": "fee schedule" }]}]} , { "description": "Hc Laryngoscopy W/Foreign Body Removal", "code_information": [ { "code": "31530", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8622.35, "discounted_cash": 2108,"minimum": 549.83,"maximum": 8622.35,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2131.62, "estimated_amount": 2131, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6897.88, "standard_charge_percentage": 80.0000, "estimated_amount": 6897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6897.88, "standard_charge_percentage": 80.0000, "estimated_amount": 6897, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6897.88, "standard_charge_percentage": 80.0000, "estimated_amount": 6897, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6035.65, "standard_charge_percentage": 70.0000, "estimated_amount": 6035, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7760.11, "standard_charge_percentage": 90.0000, "estimated_amount": 7760, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5173.41, "standard_charge_percentage": 60.0000, "estimated_amount": 5173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2190.02, "estimated_amount": 2190, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6897.88, "standard_charge_percentage": 80.0000, "estimated_amount": 6897, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4311.18, "standard_charge_percentage": 50.0000, "estimated_amount": 4311, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7760.11, "standard_charge_percentage": 90.0000, "estimated_amount": 7760, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7544.56, "standard_charge_percentage": 87.5000, "estimated_amount": 7544, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6897.88, "standard_charge_percentage": 80.0000, "estimated_amount": 6897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8622.35, "standard_charge_percentage": 100.0000, "estimated_amount": 8622, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6897.88, "standard_charge_percentage": 80.0000, "estimated_amount": 6897, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6466.76, "standard_charge_percentage": 75.0000, "estimated_amount": 6466, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5000.96, "standard_charge_percentage": 58.0000, "estimated_amount": 5000, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3001.14, "estimated_amount": 3001, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3244.48, "estimated_amount": 3244, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7544.56, "standard_charge_percentage": 87.5000, "estimated_amount": 7544, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6897.88, "standard_charge_percentage": 80.0000, "estimated_amount": 6897, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8622.35, "standard_charge_percentage": 100.0000, "estimated_amount": 8622, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2586.7, "standard_charge_percentage": 30.0000, "estimated_amount": 2586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6466.76, "standard_charge_percentage": 75.0000, "estimated_amount": 6466, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7070.33, "standard_charge_percentage": 82.0000, "estimated_amount": 7070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6897.88, "standard_charge_percentage": 80.0000, "estimated_amount": 6897, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6466.76, "standard_charge_percentage": 75.0000, "estimated_amount": 6466, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5744.14, "estimated_amount": 5744, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1654.68, "estimated_amount": 1654, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2116.92, "estimated_amount": 2116, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1602.71, "estimated_amount": 1602, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 549.83, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2102.21, "estimated_amount": 2102, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6466.76, "standard_charge_percentage": 75.0000, "estimated_amount": 6466, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6466.76, "standard_charge_percentage": 75.0000, "estimated_amount": 6466, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7760.11, "standard_charge_percentage": 90.0000, "estimated_amount": 7760, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7760.11, "standard_charge_percentage": 90.0000, "estimated_amount": 7760, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7329, "standard_charge_percentage": 85.0000, "estimated_amount": 7329, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3448.94, "standard_charge_percentage": 40.0000, "estimated_amount": 3448, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8191.23, "standard_charge_percentage": 95.0000, "estimated_amount": 8191, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5173.41, "standard_charge_percentage": 60.0000, "estimated_amount": 5173, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6897.88, "standard_charge_percentage": 80.0000, "estimated_amount": 6897, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6897.88, "standard_charge_percentage": 80.0000, "estimated_amount": 6897, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6035.65, "standard_charge_percentage": 70.0000, "estimated_amount": 6035, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6035.65, "standard_charge_percentage": 70.0000, "estimated_amount": 6035, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4828.52, "standard_charge_percentage": 56.0000, "estimated_amount": 4828, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7760.11, "standard_charge_percentage": 90.0000, "estimated_amount": 7760, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8449.9, "standard_charge_percentage": 98.0000, "estimated_amount": 8449, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" }]}]} , { "description": "DESTROY L/S FACET JNT ADDL", "code_information": [ { "code": "31622", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3193.1, "discounted_cash": 2108,"minimum": 549.83,"maximum": 7592.86,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1602.71, "estimated_amount": 1602, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2102.21, "estimated_amount": 2102, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2554.48, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1277.24, "standard_charge_percentage": 40.0000, "estimated_amount": 1277, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2793.96, "standard_charge_percentage": 87.5000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3193.1, "standard_charge_percentage": 100.0000, "estimated_amount": 3193, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 957.93, "standard_charge_percentage": 30.0000, "estimated_amount": 957, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2394.82, "standard_charge_percentage": 75.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2618.34, "standard_charge_percentage": 82.0000, "estimated_amount": 2618, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1852, "standard_charge_percentage": 58.0000, "estimated_amount": 1852, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2394.82, "standard_charge_percentage": 75.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3001.14, "estimated_amount": 3001, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7592.86, "standard_charge_percentage": 100.0000, "estimated_amount": 7592, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2277.86, "standard_charge_percentage": 30.0000, "estimated_amount": 2277, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4252, "standard_charge_percentage": 56.0000, "estimated_amount": 4252, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2190.02, "estimated_amount": 2190, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2131.62, "estimated_amount": 2131, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2554.48, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1596.55, "standard_charge_percentage": 50.0000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2873.79, "standard_charge_percentage": 90.0000, "estimated_amount": 2873, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2554.48, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3193.1, "standard_charge_percentage": 100.0000, "estimated_amount": 3193, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2554.48, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2554.48, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2394.82, "standard_charge_percentage": 75.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2235.17, "standard_charge_percentage": 70.0000, "estimated_amount": 2235, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1788.14, "standard_charge_percentage": 56.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2554.48, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2873.79, "standard_charge_percentage": 90.0000, "estimated_amount": 2873, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1915.86, "standard_charge_percentage": 60.0000, "estimated_amount": 1915, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1654.68, "estimated_amount": 1654, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2190.02, "estimated_amount": 2190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2873.79, "standard_charge_percentage": 90.0000, "estimated_amount": 2873, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2873.79, "standard_charge_percentage": 90.0000, "estimated_amount": 2873, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2554.48, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1915.86, "standard_charge_percentage": 60.0000, "estimated_amount": 1915, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2554.48, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2554.48, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2235.17, "standard_charge_percentage": 70.0000, "estimated_amount": 2235, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 3193.1, "estimated_amount": 3193, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2116.92, "estimated_amount": 2116, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3796.43, "standard_charge_percentage": 50.0000, "estimated_amount": 3796, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7592.86, "standard_charge_percentage": 100.0000, "estimated_amount": 7592, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6226.15, "standard_charge_percentage": 82.0000, "estimated_amount": 6226, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4403.86, "standard_charge_percentage": 58.0000, "estimated_amount": 4403, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7441, "standard_charge_percentage": 98.0000, "estimated_amount": 7441, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3244.48, "estimated_amount": 3244, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6453.93, "standard_charge_percentage": 85.0000, "estimated_amount": 6453, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3037.14, "standard_charge_percentage": 40.0000, "estimated_amount": 3037, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7213.22, "standard_charge_percentage": 95.0000, "estimated_amount": 7213, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4555.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4555, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5744.14, "estimated_amount": 5744, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1654.68, "estimated_amount": 1654, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3001.14, "estimated_amount": 3001, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2116.92, "estimated_amount": 2116, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 549.83, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2394.82, "standard_charge_percentage": 75.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2394.82, "standard_charge_percentage": 75.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2714.14, "standard_charge_percentage": 85.0000, "estimated_amount": 2714, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2793.96, "standard_charge_percentage": 87.5000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2554.48, "standard_charge_percentage": 80.0000, "estimated_amount": 2554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3033.45, "standard_charge_percentage": 95.0000, "estimated_amount": 3033, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2235.17, "standard_charge_percentage": 70.0000, "estimated_amount": 2235, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2873.79, "standard_charge_percentage": 90.0000, "estimated_amount": 2873, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3129.24, "standard_charge_percentage": 98.0000, "estimated_amount": 3129, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3193.1, "estimated_amount": 3193, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1602.71, "estimated_amount": 1602, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 549.83, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2131.62, "estimated_amount": 2131, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2102.21, "estimated_amount": 2102, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5694.65, "standard_charge_percentage": 75.0000, "estimated_amount": 5694, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6643.75, "standard_charge_percentage": 87.5000, "estimated_amount": 6643, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6643.75, "standard_charge_percentage": 87.5000, "estimated_amount": 6643, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6074.29, "standard_charge_percentage": 80.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4555.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4555, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5315, "standard_charge_percentage": 70.0000, "estimated_amount": 5315, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6833.57, "standard_charge_percentage": 90.0000, "estimated_amount": 6833, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" }]}]} , { "description": "Dx Bronchoscope/Brush", "code_information": [ { "code": "31623", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8799.1, "discounted_cash": 2108,"minimum": 549.83,"maximum": 8799.1,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2102.21, "estimated_amount": 2102, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7699.21, "standard_charge_percentage": 87.5000, "estimated_amount": 7699, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8359.15, "standard_charge_percentage": 95.0000, "estimated_amount": 8359, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7215.26, "standard_charge_percentage": 82.0000, "estimated_amount": 7215, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5103.48, "standard_charge_percentage": 58.0000, "estimated_amount": 5103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8623.12, "standard_charge_percentage": 98.0000, "estimated_amount": 8623, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2131.62, "estimated_amount": 2131, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4399.55, "standard_charge_percentage": 50.0000, "estimated_amount": 4399, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4927.5, "standard_charge_percentage": 56.0000, "estimated_amount": 4927, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3519.64, "standard_charge_percentage": 40.0000, "estimated_amount": 3519, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7699.21, "standard_charge_percentage": 87.5000, "estimated_amount": 7699, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8799.1, "standard_charge_percentage": 100.0000, "estimated_amount": 8799, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6159.37, "standard_charge_percentage": 70.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 60.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5744.14, "estimated_amount": 5744, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1654.68, "estimated_amount": 1654, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2190.02, "estimated_amount": 2190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2116.92, "estimated_amount": 2116, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1602.71, "estimated_amount": 1602, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 549.83, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7479.23, "standard_charge_percentage": 85.0000, "estimated_amount": 7479, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8799.1, "standard_charge_percentage": 100.0000, "estimated_amount": 8799, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5279.46, "standard_charge_percentage": 60.0000, "estimated_amount": 5279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7039.28, "standard_charge_percentage": 80.0000, "estimated_amount": 7039, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2639.73, "standard_charge_percentage": 30.0000, "estimated_amount": 2639, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6599.32, "standard_charge_percentage": 75.0000, "estimated_amount": 6599, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6159.37, "standard_charge_percentage": 70.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6159.37, "standard_charge_percentage": 70.0000, "estimated_amount": 6159, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7919.19, "standard_charge_percentage": 90.0000, "estimated_amount": 7919, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3001.14, "estimated_amount": 3001, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3244.48, "estimated_amount": 3244, "methodology": "fee schedule" }]}]} , { "description": "GUIDED CATH FLUID DRAINAGE", "code_information": [ { "code": "31624", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8348.44, "discounted_cash": 2108,"minimum": 549.83,"maximum": 8348.44,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2116.92, "estimated_amount": 2116, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2131.62, "estimated_amount": 2131, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6261.33, "standard_charge_percentage": 75.0000, "estimated_amount": 6261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7096.17, "standard_charge_percentage": 85.0000, "estimated_amount": 7096, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7931.02, "standard_charge_percentage": 95.0000, "estimated_amount": 7931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6261.33, "standard_charge_percentage": 75.0000, "estimated_amount": 6261, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5843.91, "standard_charge_percentage": 70.0000, "estimated_amount": 5843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4842.1, "standard_charge_percentage": 58.0000, "estimated_amount": 4842, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3001.14, "estimated_amount": 3001, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1602.71, "estimated_amount": 1602, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 549.83, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2102.21, "estimated_amount": 2102, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6261.33, "standard_charge_percentage": 75.0000, "estimated_amount": 6261, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7304.89, "standard_charge_percentage": 87.5000, "estimated_amount": 7304, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8348.44, "standard_charge_percentage": 100.0000, "estimated_amount": 8348, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8348.44, "standard_charge_percentage": 100.0000, "estimated_amount": 8348, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5009.06, "standard_charge_percentage": 60.0000, "estimated_amount": 5009, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7513.6, "standard_charge_percentage": 90.0000, "estimated_amount": 7513, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7513.6, "standard_charge_percentage": 90.0000, "estimated_amount": 7513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1654.68, "estimated_amount": 1654, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2190.02, "estimated_amount": 2190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4174.22, "standard_charge_percentage": 50.0000, "estimated_amount": 4174, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7513.6, "standard_charge_percentage": 90.0000, "estimated_amount": 7513, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7513.6, "standard_charge_percentage": 90.0000, "estimated_amount": 7513, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7513.6, "standard_charge_percentage": 90.0000, "estimated_amount": 7513, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3339.38, "standard_charge_percentage": 40.0000, "estimated_amount": 3339, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2504.53, "standard_charge_percentage": 30.0000, "estimated_amount": 2504, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5843.91, "standard_charge_percentage": 70.0000, "estimated_amount": 5843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6845.72, "standard_charge_percentage": 82.0000, "estimated_amount": 6845, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4675.13, "standard_charge_percentage": 56.0000, "estimated_amount": 4675, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6261.33, "standard_charge_percentage": 75.0000, "estimated_amount": 6261, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5744.14, "estimated_amount": 5744, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7304.89, "standard_charge_percentage": 87.5000, "estimated_amount": 7304, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5843.91, "standard_charge_percentage": 70.0000, "estimated_amount": 5843, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6261.33, "standard_charge_percentage": 75.0000, "estimated_amount": 6261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8181.47, "standard_charge_percentage": 98.0000, "estimated_amount": 8181, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5009.06, "standard_charge_percentage": 60.0000, "estimated_amount": 5009, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3244.48, "estimated_amount": 3244, "methodology": "fee schedule" }]}]} , { "description": "INJECTION SACROILIAC JOINT /", "code_information": [ { "code": "31628", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18375.5, "discounted_cash": 4508,"minimum": 898,"maximum": 18375.5,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 3342.31, "estimated_amount": 3342, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 13781.6, "standard_charge_percentage": 75.0000, "estimated_amount": 13781, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 15619.2, "standard_charge_percentage": 85.0000, "estimated_amount": 15619, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 16078.6, "standard_charge_percentage": 87.5000, "estimated_amount": 16078, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 14700.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14700, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 14700.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14700, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 18375.5, "standard_charge_percentage": 100.0000, "estimated_amount": 18375, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 14700.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5512.65, "standard_charge_percentage": 30.0000, "estimated_amount": 5512, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 12862.9, "standard_charge_percentage": 70.0000, "estimated_amount": 12862, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 12862.9, "standard_charge_percentage": 70.0000, "estimated_amount": 12862, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 10657.8, "standard_charge_percentage": 58.0000, "estimated_amount": 10657, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 16538, "standard_charge_percentage": 90.0000, "estimated_amount": 16537, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 13781.6, "standard_charge_percentage": 75.0000, "estimated_amount": 13781, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 11025.3, "standard_charge_percentage": 60.0000, "estimated_amount": 11025, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3468.38, "estimated_amount": 3468, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3641.8, "estimated_amount": 3641, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4682.31, "estimated_amount": 4682, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 6416.5, "estimated_amount": 6416, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 5549.41, "estimated_amount": 5549, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9187.75, "standard_charge_percentage": 50.0000, "estimated_amount": 9187, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7350.2, "standard_charge_percentage": 40.0000, "estimated_amount": 7350, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 17456.7, "standard_charge_percentage": 95.0000, "estimated_amount": 17456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 13781.6, "standard_charge_percentage": 75.0000, "estimated_amount": 13781, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 13781.6, "standard_charge_percentage": 75.0000, "estimated_amount": 13781, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 15067.9, "standard_charge_percentage": 82.0000, "estimated_amount": 15067, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10290.3, "standard_charge_percentage": 56.0000, "estimated_amount": 10290, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14700.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3468.38, "estimated_amount": 3468, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3468.38, "estimated_amount": 3468, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 5549.41, "estimated_amount": 5549, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6936.76, "estimated_amount": 6936, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4526.01, "estimated_amount": 4526, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1213.14, "estimated_amount": 1213, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4557.44, "estimated_amount": 4557, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4494.58, "estimated_amount": 4494, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 16538, "standard_charge_percentage": 90.0000, "estimated_amount": 16537, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 16538, "standard_charge_percentage": 90.0000, "estimated_amount": 16537, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 14700.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14700, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 14700.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14700, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 12281.1, "estimated_amount": 12281, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4855.73, "estimated_amount": 4855, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3468.38, "estimated_amount": 3468, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 3143.06, "estimated_amount": 3143, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 3143.06, "estimated_amount": 3143, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 13781.6, "standard_charge_percentage": 75.0000, "estimated_amount": 13781, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 14700.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14700.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14700, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 16538, "standard_charge_percentage": 90.0000, "estimated_amount": 16537, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 16078.6, "standard_charge_percentage": 87.5000, "estimated_amount": 16078, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 18375.5, "standard_charge_percentage": 100.0000, "estimated_amount": 18375, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 11025.3, "standard_charge_percentage": 60.0000, "estimated_amount": 11025, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14700.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14700, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 14700.4, "standard_charge_percentage": 80.0000, "estimated_amount": 14700, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 12862.9, "standard_charge_percentage": 70.0000, "estimated_amount": 12862, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 16538, "standard_charge_percentage": 90.0000, "estimated_amount": 16537, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 18008, "standard_charge_percentage": 98.0000, "estimated_amount": 18007, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3468.38, "estimated_amount": 3468, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3468.38, "estimated_amount": 3468, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4855.73, "estimated_amount": 4855, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3468.38, "estimated_amount": 3468, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3468.38, "estimated_amount": 3468, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3537.75, "estimated_amount": 3537, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3641.8, "estimated_amount": 3641, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3468.38, "estimated_amount": 3468, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3468.38, "estimated_amount": 3468, "methodology": "fee schedule" }]}]} , { "description": "TX SPINAL CORD LESION SUBR", "code_information": [ { "code": "31645", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8348.44, "discounted_cash": 2108,"minimum": 549.83,"maximum": 8348.44,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7513.6, "standard_charge_percentage": 90.0000, "estimated_amount": 7513, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7096.17, "standard_charge_percentage": 85.0000, "estimated_amount": 7096, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5009.06, "standard_charge_percentage": 60.0000, "estimated_amount": 5009, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6261.33, "standard_charge_percentage": 75.0000, "estimated_amount": 6261, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6845.72, "standard_charge_percentage": 82.0000, "estimated_amount": 6845, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5744.14, "estimated_amount": 5744, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1703.35, "estimated_amount": 1703, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3244.48, "estimated_amount": 3244, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 549.83, "estimated_amount": 549, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6261.33, "standard_charge_percentage": 75.0000, "estimated_amount": 6261, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4174.22, "standard_charge_percentage": 50.0000, "estimated_amount": 4174, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7513.6, "standard_charge_percentage": 90.0000, "estimated_amount": 7513, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3339.38, "standard_charge_percentage": 40.0000, "estimated_amount": 3339, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7304.89, "standard_charge_percentage": 87.5000, "estimated_amount": 7304, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7304.89, "standard_charge_percentage": 87.5000, "estimated_amount": 7304, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8348.44, "standard_charge_percentage": 100.0000, "estimated_amount": 8348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2504.53, "standard_charge_percentage": 30.0000, "estimated_amount": 2504, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5843.91, "standard_charge_percentage": 70.0000, "estimated_amount": 5843, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6261.33, "standard_charge_percentage": 75.0000, "estimated_amount": 6261, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4675.13, "standard_charge_percentage": 56.0000, "estimated_amount": 4675, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7513.6, "standard_charge_percentage": 90.0000, "estimated_amount": 7513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5009.06, "standard_charge_percentage": 60.0000, "estimated_amount": 5009, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1654.68, "estimated_amount": 1654, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2116.92, "estimated_amount": 2116, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1602.71, "estimated_amount": 1602, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1470.08, "estimated_amount": 1470, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2102.21, "estimated_amount": 2102, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7931.02, "standard_charge_percentage": 95.0000, "estimated_amount": 7931, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4842.1, "standard_charge_percentage": 58.0000, "estimated_amount": 4842, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8181.47, "standard_charge_percentage": 98.0000, "estimated_amount": 8181, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2190.02, "estimated_amount": 2190, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2271.14, "estimated_amount": 2271, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2595.58, "estimated_amount": 2595, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2131.62, "estimated_amount": 2131, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6261.33, "standard_charge_percentage": 75.0000, "estimated_amount": 6261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7513.6, "standard_charge_percentage": 90.0000, "estimated_amount": 7513, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8348.44, "standard_charge_percentage": 100.0000, "estimated_amount": 8348, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5843.91, "standard_charge_percentage": 70.0000, "estimated_amount": 5843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5843.91, "standard_charge_percentage": 70.0000, "estimated_amount": 5843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6678.75, "standard_charge_percentage": 80.0000, "estimated_amount": 6678, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7513.6, "standard_charge_percentage": 90.0000, "estimated_amount": 7513, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6261.33, "standard_charge_percentage": 75.0000, "estimated_amount": 6261, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1622.24, "estimated_amount": 1622, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3001.14, "estimated_amount": 3001, "methodology": "fee schedule" }]}]} , { "description": "Hc Catheter Aspiratn Nasotrach", "code_information": [ { "code": "31720", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1048.86, "discounted_cash": 248,"minimum": 69.09,"maximum": 1048.86,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 249.68, "estimated_amount": 249, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 786.64, "standard_charge_percentage": 75.0000, "estimated_amount": 786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 839.09, "standard_charge_percentage": 80.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 524.43, "standard_charge_percentage": 50.0000, "estimated_amount": 524, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 839.09, "standard_charge_percentage": 80.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 314.66, "standard_charge_percentage": 30.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 734.2, "standard_charge_percentage": 70.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 860.07, "standard_charge_percentage": 82.0000, "estimated_amount": 860, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 587.36, "standard_charge_percentage": 56.0000, "estimated_amount": 587, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 608.34, "standard_charge_percentage": 58.0000, "estimated_amount": 608, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 839.09, "standard_charge_percentage": 80.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 943.97, "standard_charge_percentage": 90.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 943.97, "standard_charge_percentage": 90.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 786.64, "standard_charge_percentage": 75.0000, "estimated_amount": 786, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 267.86, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 191.33, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 191.33, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 191.33, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 267.86, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 191.33, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 191.33, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 943.97, "standard_charge_percentage": 90.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 943.97, "standard_charge_percentage": 90.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 419.54, "standard_charge_percentage": 40.0000, "estimated_amount": 419, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1048.86, "standard_charge_percentage": 100.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 629.32, "standard_charge_percentage": 60.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 839.09, "standard_charge_percentage": 80.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 786.64, "standard_charge_percentage": 75.0000, "estimated_amount": 786, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 734.2, "standard_charge_percentage": 70.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 786.64, "standard_charge_percentage": 75.0000, "estimated_amount": 786, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 191.33, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 191.33, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 306.13, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 173.39, "estimated_amount": 173, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 69.09, "estimated_amount": 69, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 251.42, "estimated_amount": 251, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 247.95, "estimated_amount": 247, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1048.86, "estimated_amount": 1048, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 786.64, "standard_charge_percentage": 75.0000, "estimated_amount": 786, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 943.97, "standard_charge_percentage": 90.0000, "estimated_amount": 943, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 996.42, "standard_charge_percentage": 95.0000, "estimated_amount": 996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 839.09, "standard_charge_percentage": 80.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 839.09, "standard_charge_percentage": 80.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 388.08, "standard_charge_percentage": 37.0000, "estimated_amount": 388, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 629.32, "standard_charge_percentage": 60.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 191.33, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 200.9, "estimated_amount": 200, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 353.96, "estimated_amount": 353, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 306.13, "estimated_amount": 306, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 382.66, "estimated_amount": 382, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 191.99, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 173.39, "estimated_amount": 173, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 839.09, "standard_charge_percentage": 80.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 891.53, "standard_charge_percentage": 85.0000, "estimated_amount": 891, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 917.75, "standard_charge_percentage": 87.5000, "estimated_amount": 917, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 917.75, "standard_charge_percentage": 87.5000, "estimated_amount": 917, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 839.09, "standard_charge_percentage": 80.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 839.09, "standard_charge_percentage": 80.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 839.09, "standard_charge_percentage": 80.0000, "estimated_amount": 839, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1048.86, "standard_charge_percentage": 100.0000, "estimated_amount": 1048, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 734.2, "standard_charge_percentage": 70.0000, "estimated_amount": 734, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1027.88, "standard_charge_percentage": 98.0000, "estimated_amount": 1027, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 191.33, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 677.47, "estimated_amount": 677, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 191.33, "estimated_amount": 191, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 195.16, "estimated_amount": 195, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 258.3, "estimated_amount": 258, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 200.9, "estimated_amount": 200, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Lung/Mediastinum Bx", "code_information": [ { "code": "32408", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8071.7, "discounted_cash": 1981,"minimum": 914.55,"maximum": 8071.7,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1006.01, "estimated_amount": 1006, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6053.77, "standard_charge_percentage": 75.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4035.85, "standard_charge_percentage": 50.0000, "estimated_amount": 4035, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7264.53, "standard_charge_percentage": 90.0000, "estimated_amount": 7264, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7264.53, "standard_charge_percentage": 90.0000, "estimated_amount": 7264, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6860.94, "standard_charge_percentage": 85.0000, "estimated_amount": 6860, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8071.7, "standard_charge_percentage": 100.0000, "estimated_amount": 8071, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7668.11, "standard_charge_percentage": 95.0000, "estimated_amount": 7668, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8071.7, "standard_charge_percentage": 100.0000, "estimated_amount": 8071, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5650.19, "standard_charge_percentage": 70.0000, "estimated_amount": 5650, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5650.19, "standard_charge_percentage": 70.0000, "estimated_amount": 5650, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7264.53, "standard_charge_percentage": 90.0000, "estimated_amount": 7264, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4843.02, "standard_charge_percentage": 60.0000, "estimated_amount": 4843, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6053.77, "standard_charge_percentage": 75.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7062.74, "standard_charge_percentage": 87.5000, "estimated_amount": 7062, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4843.02, "standard_charge_percentage": 60.0000, "estimated_amount": 4843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7264.53, "standard_charge_percentage": 90.0000, "estimated_amount": 7264, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2986.53, "standard_charge_percentage": 37.0000, "estimated_amount": 2986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6457.36, "standard_charge_percentage": 80.0000, "estimated_amount": 6457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 914.55, "estimated_amount": 914, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3228.68, "standard_charge_percentage": 40.0000, "estimated_amount": 3228, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7062.74, "standard_charge_percentage": 87.5000, "estimated_amount": 7062, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2421.51, "standard_charge_percentage": 30.0000, "estimated_amount": 2421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6053.77, "standard_charge_percentage": 75.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5650.19, "standard_charge_percentage": 70.0000, "estimated_amount": 5650, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6053.77, "standard_charge_percentage": 75.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6618.79, "standard_charge_percentage": 82.0000, "estimated_amount": 6618, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4520.15, "standard_charge_percentage": 56.0000, "estimated_amount": 4520, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4681.59, "standard_charge_percentage": 58.0000, "estimated_amount": 4681, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7264.53, "standard_charge_percentage": 90.0000, "estimated_amount": 7264, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7910.27, "standard_charge_percentage": 98.0000, "estimated_amount": 7910, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6053.77, "standard_charge_percentage": 75.0000, "estimated_amount": 6053, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Indwel Tunneled Pleural Cath W Cuff", "code_information": [ { "code": "32550", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 10754.2, "discounted_cash": 4315,"minimum": 1322.27,"maximum": 10754.2,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4302.1, "estimated_amount": 4302, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 8065.65, "standard_charge_percentage": 75.0000, "estimated_amount": 8065, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 9678.78, "standard_charge_percentage": 90.0000, "estimated_amount": 9678, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 9678.78, "standard_charge_percentage": 90.0000, "estimated_amount": 9678, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 6452.52, "standard_charge_percentage": 60.0000, "estimated_amount": 6452, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 7527.94, "standard_charge_percentage": 70.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 8065.65, "standard_charge_percentage": 75.0000, "estimated_amount": 8065, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4647.79, "estimated_amount": 4647, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3319.85, "estimated_amount": 3319, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3319.85, "estimated_amount": 3319, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 5311.76, "estimated_amount": 5311, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 3551.13, "estimated_amount": 3551, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 3008.46, "estimated_amount": 3008, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 8603.36, "standard_charge_percentage": 80.0000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 8603.36, "standard_charge_percentage": 80.0000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 9678.78, "standard_charge_percentage": 90.0000, "estimated_amount": 9678, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 4301.68, "standard_charge_percentage": 40.0000, "estimated_amount": 4301, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 8603.36, "standard_charge_percentage": 80.0000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 8603.36, "standard_charge_percentage": 80.0000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 8065.65, "standard_charge_percentage": 75.0000, "estimated_amount": 8065, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 7527.94, "standard_charge_percentage": 70.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 7527.94, "standard_charge_percentage": 70.0000, "estimated_amount": 7527, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 6022.35, "standard_charge_percentage": 56.0000, "estimated_amount": 6022, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 6237.44, "standard_charge_percentage": 58.0000, "estimated_amount": 6237, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3319.85, "estimated_amount": 3319, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3319.85, "estimated_amount": 3319, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3319.85, "estimated_amount": 3319, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 10754.2, "estimated_amount": 10754, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3319.85, "estimated_amount": 3319, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3386.25, "estimated_amount": 3386, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3319.85, "estimated_amount": 3319, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 5311.76, "estimated_amount": 5311, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3485.84, "estimated_amount": 3485, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3319.85, "estimated_amount": 3319, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 6141.72, "estimated_amount": 6141, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6639.7, "estimated_amount": 6639, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 5377.1, "standard_charge_percentage": 50.0000, "estimated_amount": 5377, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 9141.07, "standard_charge_percentage": 85.0000, "estimated_amount": 9141, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 9409.93, "standard_charge_percentage": 87.5000, "estimated_amount": 9409, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 10754.2, "standard_charge_percentage": 100.0000, "estimated_amount": 10754, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 10216.5, "standard_charge_percentage": 95.0000, "estimated_amount": 10216, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 10754.2, "standard_charge_percentage": 100.0000, "estimated_amount": 10754, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 8603.36, "standard_charge_percentage": 80.0000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 8603.36, "standard_charge_percentage": 80.0000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3226.26, "standard_charge_percentage": 30.0000, "estimated_amount": 3226, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 8818.44, "standard_charge_percentage": 82.0000, "estimated_amount": 8818, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 9678.78, "standard_charge_percentage": 90.0000, "estimated_amount": 9678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 6452.52, "standard_charge_percentage": 60.0000, "estimated_amount": 6452, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4481.8, "estimated_amount": 4481, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4647.79, "estimated_amount": 4647, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4332.18, "estimated_amount": 4332, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 3008.46, "estimated_amount": 3008, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1322.27, "estimated_amount": 1322, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4362.27, "estimated_amount": 4362, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 8065.65, "standard_charge_percentage": 75.0000, "estimated_amount": 8065, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 9409.93, "standard_charge_percentage": 87.5000, "estimated_amount": 9409, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 8603.36, "standard_charge_percentage": 80.0000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 8603.36, "standard_charge_percentage": 80.0000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 8603.36, "standard_charge_percentage": 80.0000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 8065.65, "standard_charge_percentage": 75.0000, "estimated_amount": 8065, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3979.05, "standard_charge_percentage": 37.0000, "estimated_amount": 3979, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 8603.36, "standard_charge_percentage": 80.0000, "estimated_amount": 8603, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 9678.78, "standard_charge_percentage": 90.0000, "estimated_amount": 9678, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 10539.1, "standard_charge_percentage": 98.0000, "estimated_amount": 10539, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3319.85, "estimated_amount": 3319, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3485.84, "estimated_amount": 3485, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3319.85, "estimated_amount": 3319, "methodology": "fee schedule" }]}]} , { "description": "Hc Tube Thoracostomy W Drain Sys", "code_information": [ { "code": "32551", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7846.65, "discounted_cash": 1899,"minimum": 224,"maximum": 7846.65,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6277.32, "standard_charge_percentage": 80.0000, "estimated_amount": 6277, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7061.98, "standard_charge_percentage": 90.0000, "estimated_amount": 7061, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6277.32, "standard_charge_percentage": 80.0000, "estimated_amount": 6277, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7454.32, "standard_charge_percentage": 95.0000, "estimated_amount": 7454, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6277.32, "standard_charge_percentage": 80.0000, "estimated_amount": 6277, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6277.32, "standard_charge_percentage": 80.0000, "estimated_amount": 6277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2353.99, "standard_charge_percentage": 30.0000, "estimated_amount": 2353, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5492.65, "standard_charge_percentage": 70.0000, "estimated_amount": 5492, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6434.25, "standard_charge_percentage": 82.0000, "estimated_amount": 6434, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4394.12, "standard_charge_percentage": 56.0000, "estimated_amount": 4394, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4551.06, "standard_charge_percentage": 58.0000, "estimated_amount": 4551, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4707.99, "standard_charge_percentage": 60.0000, "estimated_amount": 4707, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5174.45, "estimated_amount": 5174, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1972.82, "estimated_amount": 1972, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5884.99, "standard_charge_percentage": 75.0000, "estimated_amount": 5884, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6277.32, "standard_charge_percentage": 80.0000, "estimated_amount": 6277, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5884.99, "standard_charge_percentage": 75.0000, "estimated_amount": 5884, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7061.98, "standard_charge_percentage": 90.0000, "estimated_amount": 7061, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3138.66, "standard_charge_percentage": 40.0000, "estimated_amount": 3138, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6865.82, "standard_charge_percentage": 87.5000, "estimated_amount": 6865, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6277.32, "standard_charge_percentage": 80.0000, "estimated_amount": 6277, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4707.99, "standard_charge_percentage": 60.0000, "estimated_amount": 4707, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5492.65, "standard_charge_percentage": 70.0000, "estimated_amount": 5492, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6277.32, "standard_charge_percentage": 80.0000, "estimated_amount": 6277, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7061.98, "standard_charge_percentage": 90.0000, "estimated_amount": 7061, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7689.72, "standard_charge_percentage": 98.0000, "estimated_amount": 7689, "methodology": "percent of total billed charges" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2703.5, "estimated_amount": 2703, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2922.7, "estimated_amount": 2922, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 224, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3923.32, "standard_charge_percentage": 50.0000, "estimated_amount": 3923, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7846.65, "standard_charge_percentage": 100.0000, "estimated_amount": 7846, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7846.65, "standard_charge_percentage": 100.0000, "estimated_amount": 7846, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6277.32, "standard_charge_percentage": 80.0000, "estimated_amount": 6277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5884.99, "standard_charge_percentage": 75.0000, "estimated_amount": 5884, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5884.99, "standard_charge_percentage": 75.0000, "estimated_amount": 5884, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7061.98, "standard_charge_percentage": 90.0000, "estimated_amount": 7061, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6669.65, "standard_charge_percentage": 85.0000, "estimated_amount": 6669, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6865.82, "standard_charge_percentage": 87.5000, "estimated_amount": 6865, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6277.32, "standard_charge_percentage": 80.0000, "estimated_amount": 6277, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6277.32, "standard_charge_percentage": 80.0000, "estimated_amount": 6277, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5492.65, "standard_charge_percentage": 70.0000, "estimated_amount": 5492, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2903.26, "standard_charge_percentage": 37.0000, "estimated_amount": 2903, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7061.98, "standard_charge_percentage": 90.0000, "estimated_amount": 7061, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5884.99, "standard_charge_percentage": 75.0000, "estimated_amount": 5884, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1490.58, "estimated_amount": 1490, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" }]}]} , { "description": "Hc Remv Indwelling Tunneled Pleural Cath W Cuff", "code_information": [ { "code": "32552", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2262.6, "discounted_cash": 756,"minimum": 51.23,"maximum": 2262.6,"payers_information":[{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 764.24, "estimated_amount": 764, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1979.78, "standard_charge_percentage": 87.5000, "estimated_amount": 1979, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1583.82, "standard_charge_percentage": 70.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1267.06, "standard_charge_percentage": 56.0000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 758.97, "estimated_amount": 758, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 580.01, "estimated_amount": 580, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 51.23, "estimated_amount": 51, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1923.21, "standard_charge_percentage": 85.0000, "estimated_amount": 1923, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1979.78, "standard_charge_percentage": 87.5000, "estimated_amount": 1979, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2262.6, "standard_charge_percentage": 100.0000, "estimated_amount": 2262, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1357.56, "standard_charge_percentage": 60.0000, "estimated_amount": 1357, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1583.82, "standard_charge_percentage": 70.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1583.82, "standard_charge_percentage": 70.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1855.33, "standard_charge_percentage": 82.0000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1312.31, "standard_charge_percentage": 58.0000, "estimated_amount": 1312, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 837.16, "standard_charge_percentage": 37.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 593.23, "estimated_amount": 593, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1131.3, "standard_charge_percentage": 50.0000, "estimated_amount": 1131, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2217.35, "standard_charge_percentage": 98.0000, "estimated_amount": 2217, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 785.16, "estimated_amount": 785, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1075.96, "estimated_amount": 1075, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1163.2, "estimated_amount": 1163, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 753.7, "estimated_amount": 753, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 905.04, "standard_charge_percentage": 40.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2149.47, "standard_charge_percentage": 95.0000, "estimated_amount": 2149, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2262.6, "standard_charge_percentage": 100.0000, "estimated_amount": 2262, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 678.78, "standard_charge_percentage": 30.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1357.56, "standard_charge_percentage": 60.0000, "estimated_amount": 1357, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2059.37, "estimated_amount": 2059, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" }]}]} , { "description": "Hc Thoracentesis Ndl/Cath Pleura Asp Wo Imag", "code_information": [ { "code": "32554", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3091.3, "discounted_cash": 756,"minimum": 278.77,"maximum": 3091.3,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 580.01, "estimated_amount": 580, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2473.04, "standard_charge_percentage": 80.0000, "estimated_amount": 2473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1545.65, "standard_charge_percentage": 50.0000, "estimated_amount": 1545, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2704.89, "standard_charge_percentage": 87.5000, "estimated_amount": 2704, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2473.04, "standard_charge_percentage": 80.0000, "estimated_amount": 2473, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1854.78, "standard_charge_percentage": 60.0000, "estimated_amount": 1854, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2473.04, "standard_charge_percentage": 80.0000, "estimated_amount": 2473, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2534.87, "standard_charge_percentage": 82.0000, "estimated_amount": 2534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2473.04, "standard_charge_percentage": 80.0000, "estimated_amount": 2473, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2782.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2059.37, "estimated_amount": 2059, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 593.23, "estimated_amount": 593, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1163.2, "estimated_amount": 1163, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 278.77, "estimated_amount": 278, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 753.7, "estimated_amount": 753, "methodology": "fee schedule" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3091.3, "standard_charge_percentage": 100.0000, "estimated_amount": 3091, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2473.04, "standard_charge_percentage": 80.0000, "estimated_amount": 2473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2318.47, "standard_charge_percentage": 75.0000, "estimated_amount": 2318, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2163.91, "standard_charge_percentage": 70.0000, "estimated_amount": 2163, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2163.91, "standard_charge_percentage": 70.0000, "estimated_amount": 2163, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2163.91, "standard_charge_percentage": 70.0000, "estimated_amount": 2163, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1792.95, "standard_charge_percentage": 58.0000, "estimated_amount": 1792, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 758.97, "estimated_amount": 758, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 764.24, "estimated_amount": 764, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2318.47, "standard_charge_percentage": 75.0000, "estimated_amount": 2318, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2782.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2782.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2704.89, "standard_charge_percentage": 87.5000, "estimated_amount": 2704, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2473.04, "standard_charge_percentage": 80.0000, "estimated_amount": 2473, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3091.3, "standard_charge_percentage": 100.0000, "estimated_amount": 3091, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2936.74, "standard_charge_percentage": 95.0000, "estimated_amount": 2936, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2473.04, "standard_charge_percentage": 80.0000, "estimated_amount": 2473, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2473.04, "standard_charge_percentage": 80.0000, "estimated_amount": 2473, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 927.39, "standard_charge_percentage": 30.0000, "estimated_amount": 927, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1731.13, "standard_charge_percentage": 56.0000, "estimated_amount": 1731, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3029.47, "standard_charge_percentage": 98.0000, "estimated_amount": 3029, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 785.16, "estimated_amount": 785, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1075.96, "estimated_amount": 1075, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2318.47, "standard_charge_percentage": 75.0000, "estimated_amount": 2318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2473.04, "standard_charge_percentage": 80.0000, "estimated_amount": 2473, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2782.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2627.61, "standard_charge_percentage": 85.0000, "estimated_amount": 2627, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1236.52, "standard_charge_percentage": 40.0000, "estimated_amount": 1236, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2473.04, "standard_charge_percentage": 80.0000, "estimated_amount": 2473, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2318.47, "standard_charge_percentage": 75.0000, "estimated_amount": 2318, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1143.78, "standard_charge_percentage": 37.0000, "estimated_amount": 1143, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2782.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2318.47, "standard_charge_percentage": 75.0000, "estimated_amount": 2318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1854.78, "standard_charge_percentage": 60.0000, "estimated_amount": 1854, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" }]}]} , { "description": "Hc Thoracentesis Ndl/Cath Pleura Asp W Imag", "code_information": [ { "code": "32555", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5918.1, "discounted_cash": 756,"minimum": 278.77,"maximum": 5918.1,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 764.24, "estimated_amount": 764, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4438.57, "standard_charge_percentage": 75.0000, "estimated_amount": 4438, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4438.57, "standard_charge_percentage": 75.0000, "estimated_amount": 4438, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5326.29, "standard_charge_percentage": 90.0000, "estimated_amount": 5326, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4734.48, "standard_charge_percentage": 80.0000, "estimated_amount": 4734, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4734.48, "standard_charge_percentage": 80.0000, "estimated_amount": 4734, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4734.48, "standard_charge_percentage": 80.0000, "estimated_amount": 4734, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5622.19, "standard_charge_percentage": 95.0000, "estimated_amount": 5622, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4142.67, "standard_charge_percentage": 70.0000, "estimated_amount": 4142, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4142.67, "standard_charge_percentage": 70.0000, "estimated_amount": 4142, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5326.29, "standard_charge_percentage": 90.0000, "estimated_amount": 5326, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5326.29, "standard_charge_percentage": 90.0000, "estimated_amount": 5326, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4438.57, "standard_charge_percentage": 75.0000, "estimated_amount": 4438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 785.16, "estimated_amount": 785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 758.97, "estimated_amount": 758, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 580.01, "estimated_amount": 580, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4734.48, "standard_charge_percentage": 80.0000, "estimated_amount": 4734, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5030.39, "standard_charge_percentage": 85.0000, "estimated_amount": 5030, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5178.34, "standard_charge_percentage": 87.5000, "estimated_amount": 5178, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5178.34, "standard_charge_percentage": 87.5000, "estimated_amount": 5178, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5918.1, "standard_charge_percentage": 100.0000, "estimated_amount": 5918, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3550.86, "standard_charge_percentage": 60.0000, "estimated_amount": 3550, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4734.48, "standard_charge_percentage": 80.0000, "estimated_amount": 4734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1775.43, "standard_charge_percentage": 30.0000, "estimated_amount": 1775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4438.57, "standard_charge_percentage": 75.0000, "estimated_amount": 4438, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4852.84, "standard_charge_percentage": 82.0000, "estimated_amount": 4852, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2189.7, "standard_charge_percentage": 37.0000, "estimated_amount": 2189, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4734.48, "standard_charge_percentage": 80.0000, "estimated_amount": 4734, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 593.23, "estimated_amount": 593, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4734.48, "standard_charge_percentage": 80.0000, "estimated_amount": 4734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2959.05, "standard_charge_percentage": 50.0000, "estimated_amount": 2959, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5326.29, "standard_charge_percentage": 90.0000, "estimated_amount": 5326, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5918.1, "standard_charge_percentage": 100.0000, "estimated_amount": 5918, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4734.48, "standard_charge_percentage": 80.0000, "estimated_amount": 4734, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4142.67, "standard_charge_percentage": 70.0000, "estimated_amount": 4142, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3314.14, "standard_charge_percentage": 56.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5799.74, "standard_charge_percentage": 98.0000, "estimated_amount": 5799, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3550.86, "standard_charge_percentage": 60.0000, "estimated_amount": 3550, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1075.96, "estimated_amount": 1075, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1163.2, "estimated_amount": 1163, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 278.77, "estimated_amount": 278, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 753.7, "estimated_amount": 753, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5326.29, "standard_charge_percentage": 90.0000, "estimated_amount": 5326, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2367.24, "standard_charge_percentage": 40.0000, "estimated_amount": 2367, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4734.48, "standard_charge_percentage": 80.0000, "estimated_amount": 4734, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4734.48, "standard_charge_percentage": 80.0000, "estimated_amount": 4734, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4438.57, "standard_charge_percentage": 75.0000, "estimated_amount": 4438, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3432.5, "standard_charge_percentage": 58.0000, "estimated_amount": 3432, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2059.37, "estimated_amount": 2059, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Indwel Cath Pleural Drain Wo Img", "code_information": [ { "code": "32556", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9484.95, "discounted_cash": 2319,"minimum": 278.77,"maximum": 9484.95,"payers_information":[{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4742.48, "standard_charge_percentage": 50.0000, "estimated_amount": 4742, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8299.33, "standard_charge_percentage": 87.5000, "estimated_amount": 8299, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 9010.7, "standard_charge_percentage": 95.0000, "estimated_amount": 9010, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9484.95, "standard_charge_percentage": 100.0000, "estimated_amount": 9484, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7587.96, "standard_charge_percentage": 80.0000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6639.47, "standard_charge_percentage": 70.0000, "estimated_amount": 6639, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7113.71, "standard_charge_percentage": 75.0000, "estimated_amount": 7113, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7777.66, "standard_charge_percentage": 82.0000, "estimated_amount": 7777, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5501.27, "standard_charge_percentage": 58.0000, "estimated_amount": 5501, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5690.97, "standard_charge_percentage": 60.0000, "estimated_amount": 5690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1784.53, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1784.53, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1784.53, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2855.25, "estimated_amount": 2855, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1784.53, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3301.38, "estimated_amount": 3301, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3569.06, "estimated_amount": 3569, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1617.15, "estimated_amount": 1617, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8536.46, "standard_charge_percentage": 90.0000, "estimated_amount": 8536, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3793.98, "standard_charge_percentage": 40.0000, "estimated_amount": 3793, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7587.96, "standard_charge_percentage": 80.0000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7587.96, "standard_charge_percentage": 80.0000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9484.95, "standard_charge_percentage": 100.0000, "estimated_amount": 9484, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7113.71, "standard_charge_percentage": 75.0000, "estimated_amount": 7113, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5311.57, "standard_charge_percentage": 56.0000, "estimated_amount": 5311, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2498.34, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1784.53, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2498.34, "estimated_amount": 2498, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2328.7, "estimated_amount": 2328, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1617.15, "estimated_amount": 1617, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1746.11, "estimated_amount": 1746, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7113.71, "standard_charge_percentage": 75.0000, "estimated_amount": 7113, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7587.96, "standard_charge_percentage": 80.0000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7587.96, "standard_charge_percentage": 80.0000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8536.46, "standard_charge_percentage": 90.0000, "estimated_amount": 8536, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8536.46, "standard_charge_percentage": 90.0000, "estimated_amount": 8536, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8299.33, "standard_charge_percentage": 87.5000, "estimated_amount": 8299, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7587.96, "standard_charge_percentage": 80.0000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5690.97, "standard_charge_percentage": 60.0000, "estimated_amount": 5690, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7587.96, "standard_charge_percentage": 80.0000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7587.96, "standard_charge_percentage": 80.0000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7587.96, "standard_charge_percentage": 80.0000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6639.47, "standard_charge_percentage": 70.0000, "estimated_amount": 6639, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3509.43, "standard_charge_percentage": 37.0000, "estimated_amount": 3509, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8536.46, "standard_charge_percentage": 90.0000, "estimated_amount": 8536, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8536.46, "standard_charge_percentage": 90.0000, "estimated_amount": 8536, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7113.71, "standard_charge_percentage": 75.0000, "estimated_amount": 7113, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6318.78, "estimated_amount": 6318, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1873.76, "estimated_amount": 1873, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1820.22, "estimated_amount": 1820, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1784.53, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1784.53, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 278.77, "estimated_amount": 278, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2344.87, "estimated_amount": 2344, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2312.52, "estimated_amount": 2312, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7113.71, "standard_charge_percentage": 75.0000, "estimated_amount": 7113, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 8062.21, "standard_charge_percentage": 85.0000, "estimated_amount": 8062, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2845.49, "standard_charge_percentage": 30.0000, "estimated_amount": 2845, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6639.47, "standard_charge_percentage": 70.0000, "estimated_amount": 6639, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7587.96, "standard_charge_percentage": 80.0000, "estimated_amount": 7587, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9295.25, "standard_charge_percentage": 98.0000, "estimated_amount": 9295, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1784.53, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1784.53, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1784.53, "estimated_amount": 1784, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2409.12, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1873.76, "estimated_amount": 1873, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2855.25, "estimated_amount": 2855, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Indwel Cath Pleural Drain W Img", "code_information": [ { "code": "32557", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3586.66, "discounted_cash": 1899,"minimum": 278.77,"maximum": 3586.66,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 278.77, "estimated_amount": 278, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3048.66, "standard_charge_percentage": 85.0000, "estimated_amount": 3048, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3138.33, "standard_charge_percentage": 87.5000, "estimated_amount": 3138, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3138.33, "standard_charge_percentage": 87.5000, "estimated_amount": 3138, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3586.66, "standard_charge_percentage": 100.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3407.33, "standard_charge_percentage": 95.0000, "estimated_amount": 3407, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1076, "standard_charge_percentage": 30.0000, "estimated_amount": 1076, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2080.26, "standard_charge_percentage": 58.0000, "estimated_amount": 2080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2152, "standard_charge_percentage": 60.0000, "estimated_amount": 2152, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 3586.66, "estimated_amount": 3586, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1793.33, "standard_charge_percentage": 50.0000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1490.58, "estimated_amount": 1490, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1972.82, "estimated_amount": 1972, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2922.7, "estimated_amount": 2922, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1434.66, "standard_charge_percentage": 40.0000, "estimated_amount": 1434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3586.66, "standard_charge_percentage": 100.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2941.06, "standard_charge_percentage": 82.0000, "estimated_amount": 2941, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2703.5, "estimated_amount": 2703, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2152, "standard_charge_percentage": 60.0000, "estimated_amount": 2152, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2008.53, "standard_charge_percentage": 56.0000, "estimated_amount": 2008, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1327.06, "standard_charge_percentage": 37.0000, "estimated_amount": 1327, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3514.93, "standard_charge_percentage": 98.0000, "estimated_amount": 3514, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" }]}]} , { "description": "Hc Instill Via Chest Tube For Fibrinolysis, 1St Day", "code_information": [ { "code": "32561", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2262.6, "discounted_cash": 756,"minimum": 201.1,"maximum": 2262.6,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 764.24, "estimated_amount": 764, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1357.56, "standard_charge_percentage": 60.0000, "estimated_amount": 1357, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2059.37, "estimated_amount": 2059, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 593.23, "estimated_amount": 593, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1075.96, "estimated_amount": 1075, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1163.2, "estimated_amount": 1163, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 580.01, "estimated_amount": 580, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1923.21, "standard_charge_percentage": 85.0000, "estimated_amount": 1923, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1979.78, "standard_charge_percentage": 87.5000, "estimated_amount": 1979, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2262.6, "standard_charge_percentage": 100.0000, "estimated_amount": 2262, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1583.82, "standard_charge_percentage": 70.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1855.33, "standard_charge_percentage": 82.0000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1312.31, "standard_charge_percentage": 58.0000, "estimated_amount": 1312, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2217.35, "standard_charge_percentage": 98.0000, "estimated_amount": 2217, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 785.16, "estimated_amount": 785, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 758.97, "estimated_amount": 758, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 753.7, "estimated_amount": 753, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 905.04, "standard_charge_percentage": 40.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2149.47, "standard_charge_percentage": 95.0000, "estimated_amount": 2149, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2262.6, "standard_charge_percentage": 100.0000, "estimated_amount": 2262, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 678.78, "standard_charge_percentage": 30.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1583.82, "standard_charge_percentage": 70.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 837.16, "standard_charge_percentage": 37.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 201.1, "estimated_amount": 201, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1131.3, "standard_charge_percentage": 50.0000, "estimated_amount": 1131, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1979.78, "standard_charge_percentage": 87.5000, "estimated_amount": 1979, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1357.56, "standard_charge_percentage": 60.0000, "estimated_amount": 1357, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1583.82, "standard_charge_percentage": 70.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1267.06, "standard_charge_percentage": 56.0000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" }]}]} , { "description": "Hc Instill Via Chest Tube For Fibrinolysis, Subq Day", "code_information": [ { "code": "32562", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2262.6, "discounted_cash": 756,"minimum": 201.1,"maximum": 2262.6,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 758.97, "estimated_amount": 758, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2149.47, "standard_charge_percentage": 95.0000, "estimated_amount": 2149, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2262.6, "standard_charge_percentage": 100.0000, "estimated_amount": 2262, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 837.16, "standard_charge_percentage": 37.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2217.35, "standard_charge_percentage": 98.0000, "estimated_amount": 2217, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 785.16, "estimated_amount": 785, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 201.1, "estimated_amount": 201, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 764.24, "estimated_amount": 764, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1131.3, "standard_charge_percentage": 50.0000, "estimated_amount": 1131, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 905.04, "standard_charge_percentage": 40.0000, "estimated_amount": 905, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1979.78, "standard_charge_percentage": 87.5000, "estimated_amount": 1979, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1583.82, "standard_charge_percentage": 70.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1267.06, "standard_charge_percentage": 56.0000, "estimated_amount": 1267, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1075.96, "estimated_amount": 1075, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1357.56, "standard_charge_percentage": 60.0000, "estimated_amount": 1357, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1583.82, "standard_charge_percentage": 70.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1312.31, "standard_charge_percentage": 58.0000, "estimated_amount": 1312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1163.2, "estimated_amount": 1163, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 580.01, "estimated_amount": 580, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 753.7, "estimated_amount": 753, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1923.21, "standard_charge_percentage": 85.0000, "estimated_amount": 1923, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1979.78, "standard_charge_percentage": 87.5000, "estimated_amount": 1979, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2262.6, "standard_charge_percentage": 100.0000, "estimated_amount": 2262, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1810.08, "standard_charge_percentage": 80.0000, "estimated_amount": 1810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 678.78, "standard_charge_percentage": 30.0000, "estimated_amount": 678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1583.82, "standard_charge_percentage": 70.0000, "estimated_amount": 1583, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1855.33, "standard_charge_percentage": 82.0000, "estimated_amount": 1855, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2036.34, "standard_charge_percentage": 90.0000, "estimated_amount": 2036, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1696.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1696, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1357.56, "standard_charge_percentage": 60.0000, "estimated_amount": 1357, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2059.37, "estimated_amount": 2059, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 593.23, "estimated_amount": 593, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" }]}]} , { "description": "Hc Pericardiocentesis W/Img Guidance When Performed", "code_information": [ { "code": "33016", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3990.53, "discounted_cash": 1899,"minimum": 1060.23,"maximum": 3990.53,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 1060.23, "estimated_amount": 1060, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1060.23, "estimated_amount": 1060, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1995.27, "standard_charge_percentage": 50.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3391.95, "standard_charge_percentage": 85.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3272.23, "standard_charge_percentage": 82.0000, "estimated_amount": 3272, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1476.5, "standard_charge_percentage": 37.0000, "estimated_amount": 1476, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3910.72, "standard_charge_percentage": 98.0000, "estimated_amount": 3910, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1596.21, "standard_charge_percentage": 40.0000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3491.71, "standard_charge_percentage": 87.5000, "estimated_amount": 3491, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3990.53, "standard_charge_percentage": 100.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3791, "standard_charge_percentage": 95.0000, "estimated_amount": 3791, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3990.53, "standard_charge_percentage": 100.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2234.7, "standard_charge_percentage": 56.0000, "estimated_amount": 2234, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2314.51, "standard_charge_percentage": 58.0000, "estimated_amount": 2314, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1972.82, "estimated_amount": 1972, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3491.71, "standard_charge_percentage": 87.5000, "estimated_amount": 3491, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1197.16, "standard_charge_percentage": 30.0000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2394.32, "standard_charge_percentage": 60.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1490.58, "estimated_amount": 1490, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2922.7, "estimated_amount": 2922, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2394.32, "standard_charge_percentage": 60.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2703.5, "estimated_amount": 2703, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Ventr Pm W Transvenous Electrode", "code_information": [ { "code": "33207", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 35567.1, "discounted_cash": 12798,"minimum": 5151,"maximum": 35567.1,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5151, "estimated_amount": 5151, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 14226.8, "standard_charge_percentage": 40.0000, "estimated_amount": 14226, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 35567.1, "standard_charge_percentage": 100.0000, "estimated_amount": 35567, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 21340.3, "standard_charge_percentage": 60.0000, "estimated_amount": 21340, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 24897, "standard_charge_percentage": 70.0000, "estimated_amount": 24896, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 34855.8, "standard_charge_percentage": 98.0000, "estimated_amount": 34855, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 13782.9, "estimated_amount": 13782, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 13290.7, "estimated_amount": 13290, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 15751.9, "estimated_amount": 15751, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 12847, "estimated_amount": 12846, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10355.6, "estimated_amount": 10355, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 31121.2, "standard_charge_percentage": 87.5000, "estimated_amount": 31121, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 31121.2, "standard_charge_percentage": 87.5000, "estimated_amount": 31121, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 33788.8, "standard_charge_percentage": 95.0000, "estimated_amount": 33788, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 24897, "standard_charge_percentage": 70.0000, "estimated_amount": 24896, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 20628.9, "standard_charge_percentage": 58.0000, "estimated_amount": 20628, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 15751.9, "estimated_amount": 15751, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 8921.5, "estimated_amount": 8921, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 7143.53, "estimated_amount": 7143, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 35567.1, "standard_charge_percentage": 100.0000, "estimated_amount": 35567, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 24897, "standard_charge_percentage": 70.0000, "estimated_amount": 24896, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 13159.8, "standard_charge_percentage": 37.0000, "estimated_amount": 13159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10041.8, "estimated_amount": 10041, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 13782.9, "estimated_amount": 13782, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 19689.9, "estimated_amount": 19689, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 8921.5, "estimated_amount": 8921, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 12936.2, "estimated_amount": 12936, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 12757.7, "estimated_amount": 12757, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 17783.5, "standard_charge_percentage": 50.0000, "estimated_amount": 17783, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 30232, "standard_charge_percentage": 85.0000, "estimated_amount": 30232, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10670.1, "standard_charge_percentage": 30.0000, "estimated_amount": 10670, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 29165, "standard_charge_percentage": 82.0000, "estimated_amount": 29165, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 19917.6, "standard_charge_percentage": 56.0000, "estimated_amount": 19917, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 21340.3, "standard_charge_percentage": 60.0000, "estimated_amount": 21340, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 34859.6, "estimated_amount": 34859, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 10337.2, "estimated_amount": 10337, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 10337.2, "estimated_amount": 10337, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 18213.1, "estimated_amount": 18213, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Art & Ventr Pm W Transvenous Electrod", "code_information": [ { "code": "33208", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 35567.1, "discounted_cash": 12798,"minimum": 5151,"maximum": 35567.1,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 8921.5, "estimated_amount": 8921, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 35567.1, "standard_charge_percentage": 100.0000, "estimated_amount": 35567, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 21340.3, "standard_charge_percentage": 60.0000, "estimated_amount": 21340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 24897, "standard_charge_percentage": 70.0000, "estimated_amount": 24896, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 24897, "standard_charge_percentage": 70.0000, "estimated_amount": 24896, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 10337.2, "estimated_amount": 10337, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 13782.9, "estimated_amount": 13782, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 15751.9, "estimated_amount": 15751, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 12847, "estimated_amount": 12846, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 12936.2, "estimated_amount": 12936, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 31121.2, "standard_charge_percentage": 87.5000, "estimated_amount": 31121, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 31121.2, "standard_charge_percentage": 87.5000, "estimated_amount": 31121, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10670.1, "standard_charge_percentage": 30.0000, "estimated_amount": 10670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 24897, "standard_charge_percentage": 70.0000, "estimated_amount": 24896, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 19917.6, "standard_charge_percentage": 56.0000, "estimated_amount": 19917, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 13159.8, "standard_charge_percentage": 37.0000, "estimated_amount": 13159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 13782.9, "estimated_amount": 13782, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10041.8, "estimated_amount": 10041, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 13290.7, "estimated_amount": 13290, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 15751.9, "estimated_amount": 15751, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 18213.1, "estimated_amount": 18213, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 19689.9, "estimated_amount": 19689, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 8921.5, "estimated_amount": 8921, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 8810, "estimated_amount": 8810, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5151, "estimated_amount": 5151, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 33788.8, "standard_charge_percentage": 95.0000, "estimated_amount": 33788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 35567.1, "standard_charge_percentage": 100.0000, "estimated_amount": 35567, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 20628.9, "standard_charge_percentage": 58.0000, "estimated_amount": 20628, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 34855.8, "standard_charge_percentage": 98.0000, "estimated_amount": 34855, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 34859.6, "estimated_amount": 34859, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 10337.2, "estimated_amount": 10337, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10355.6, "estimated_amount": 10355, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 12757.7, "estimated_amount": 12757, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 17783.5, "standard_charge_percentage": 50.0000, "estimated_amount": 17783, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 30232, "standard_charge_percentage": 85.0000, "estimated_amount": 30232, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 14226.8, "standard_charge_percentage": 40.0000, "estimated_amount": 14226, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 29165, "standard_charge_percentage": 82.0000, "estimated_amount": 29165, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 21340.3, "standard_charge_percentage": 60.0000, "estimated_amount": 21340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Temp Pm/Electrode Single Chmbr", "code_information": [ { "code": "33210", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 26894.2, "discounted_cash": 10120,"minimum": 4081,"maximum": 26894.2,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 10159.4, "estimated_amount": 10159, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 10088.8, "estimated_amount": 10088, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 13447.1, "standard_charge_percentage": 50.0000, "estimated_amount": 13447, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 24204.8, "standard_charge_percentage": 90.0000, "estimated_amount": 24204, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 22860.1, "standard_charge_percentage": 85.0000, "estimated_amount": 22860, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 23532.4, "standard_charge_percentage": 87.5000, "estimated_amount": 23532, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 21515.4, "standard_charge_percentage": 80.0000, "estimated_amount": 21515, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 21515.4, "standard_charge_percentage": 80.0000, "estimated_amount": 21515, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 26894.2, "standard_charge_percentage": 100.0000, "estimated_amount": 26894, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 21515.4, "standard_charge_percentage": 80.0000, "estimated_amount": 21515, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 21515.4, "standard_charge_percentage": 80.0000, "estimated_amount": 21515, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 21515.4, "standard_charge_percentage": 80.0000, "estimated_amount": 21515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 20170.7, "standard_charge_percentage": 75.0000, "estimated_amount": 20170, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 18825.9, "standard_charge_percentage": 70.0000, "estimated_amount": 18825, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 15060.8, "standard_charge_percentage": 56.0000, "estimated_amount": 15060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 21515.4, "standard_charge_percentage": 80.0000, "estimated_amount": 21515, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 24204.8, "standard_charge_percentage": 90.0000, "estimated_amount": 24204, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 16136.5, "standard_charge_percentage": 60.0000, "estimated_amount": 16136, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 20170.7, "standard_charge_percentage": 75.0000, "estimated_amount": 20170, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 24204.8, "standard_charge_percentage": 90.0000, "estimated_amount": 24204, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 16136.5, "standard_charge_percentage": 60.0000, "estimated_amount": 16136, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 18825.9, "standard_charge_percentage": 70.0000, "estimated_amount": 18825, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 24204.8, "standard_charge_percentage": 90.0000, "estimated_amount": 24204, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 26894.2, "estimated_amount": 26894, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 8183.99, "estimated_amount": 8183, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 10229.9, "estimated_amount": 10229, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 21515.4, "standard_charge_percentage": 80.0000, "estimated_amount": 21515, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 10757.7, "standard_charge_percentage": 40.0000, "estimated_amount": 10757, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 23532.4, "standard_charge_percentage": 87.5000, "estimated_amount": 23532, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 25549.5, "standard_charge_percentage": 95.0000, "estimated_amount": 25549, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 26894.2, "standard_charge_percentage": 100.0000, "estimated_amount": 26894, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 21515.4, "standard_charge_percentage": 80.0000, "estimated_amount": 21515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 8068.26, "standard_charge_percentage": 30.0000, "estimated_amount": 8068, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 20170.7, "standard_charge_percentage": 75.0000, "estimated_amount": 20170, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 15598.6, "standard_charge_percentage": 58.0000, "estimated_amount": 15598, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 9950.85, "standard_charge_percentage": 37.0000, "estimated_amount": 9950, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 26356.3, "standard_charge_percentage": 98.0000, "estimated_amount": 26356, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 20170.7, "standard_charge_percentage": 75.0000, "estimated_amount": 20170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 20170.7, "standard_charge_percentage": 75.0000, "estimated_amount": 20170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 21515.4, "standard_charge_percentage": 80.0000, "estimated_amount": 21515, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 24204.8, "standard_charge_percentage": 90.0000, "estimated_amount": 24204, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 21515.4, "standard_charge_percentage": 80.0000, "estimated_amount": 21515, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 18825.9, "standard_charge_percentage": 70.0000, "estimated_amount": 18825, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 22053.2, "standard_charge_percentage": 82.0000, "estimated_amount": 22053, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 7941.08, "estimated_amount": 7941, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 10510.3, "estimated_amount": 10510, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 14402.9, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 15570.7, "estimated_amount": 15570, "methodology": "fee schedule" }]}]} , { "description": "Hc Upgrade/Convers Pacemaker Sys, Single To Dual", "code_information": [ { "code": "33214", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 54789, "discounted_cash": 12798,"minimum": 3459.21,"maximum": 54789,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 12847, "estimated_amount": 12846, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10355.6, "estimated_amount": 10355, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 12936.2, "estimated_amount": 12936, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 49310.1, "standard_charge_percentage": 90.0000, "estimated_amount": 49310, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 49310.1, "standard_charge_percentage": 90.0000, "estimated_amount": 49310, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 21915.6, "standard_charge_percentage": 40.0000, "estimated_amount": 21915, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 47940.4, "standard_charge_percentage": 87.5000, "estimated_amount": 47940, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 38352.3, "standard_charge_percentage": 70.0000, "estimated_amount": 38352, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 38352.3, "standard_charge_percentage": 70.0000, "estimated_amount": 38352, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 44927, "standard_charge_percentage": 82.0000, "estimated_amount": 44926, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 31777.6, "standard_charge_percentage": 58.0000, "estimated_amount": 31777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 43831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43831, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 49310.1, "standard_charge_percentage": 90.0000, "estimated_amount": 49310, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 13782.9, "estimated_amount": 13782, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10041.8, "estimated_amount": 10041, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 18213.1, "estimated_amount": 18213, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 19689.9, "estimated_amount": 19689, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5151, "estimated_amount": 5151, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 41091.8, "standard_charge_percentage": 75.0000, "estimated_amount": 41091, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 43831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43831, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 49310.1, "standard_charge_percentage": 90.0000, "estimated_amount": 49310, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 46570.7, "standard_charge_percentage": 85.0000, "estimated_amount": 46570, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 54789, "standard_charge_percentage": 100.0000, "estimated_amount": 54789, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 43831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43831, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 43831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43831, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 43831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43831, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 38352.3, "standard_charge_percentage": 70.0000, "estimated_amount": 38352, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 41091.8, "standard_charge_percentage": 75.0000, "estimated_amount": 41091, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 30681.8, "standard_charge_percentage": 56.0000, "estimated_amount": 30681, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 53693.2, "standard_charge_percentage": 98.0000, "estimated_amount": 53693, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 41091.8, "standard_charge_percentage": 75.0000, "estimated_amount": 41091, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 13782.9, "estimated_amount": 13782, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 8921.5, "estimated_amount": 8921, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 12757.7, "estimated_amount": 12757, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 41091.8, "standard_charge_percentage": 75.0000, "estimated_amount": 41091, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 43831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43831, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 47940.4, "standard_charge_percentage": 87.5000, "estimated_amount": 47940, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 43831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43831, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 43831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43831, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 43831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43831, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 32873.4, "standard_charge_percentage": 60.0000, "estimated_amount": 32873, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 43831.2, "standard_charge_percentage": 80.0000, "estimated_amount": 43831, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 16436.7, "standard_charge_percentage": 30.0000, "estimated_amount": 16436, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 49310.1, "standard_charge_percentage": 90.0000, "estimated_amount": 49310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 32873.4, "standard_charge_percentage": 60.0000, "estimated_amount": 32873, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 34859.6, "estimated_amount": 34859, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 10337.2, "estimated_amount": 10337, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 13290.7, "estimated_amount": 13290, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 10337.2, "estimated_amount": 10337, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 8921.5, "estimated_amount": 8921, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 3459.21, "estimated_amount": 3459, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 27394.5, "standard_charge_percentage": 50.0000, "estimated_amount": 27394, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 54789, "standard_charge_percentage": 100.0000, "estimated_amount": 54789, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 52049.6, "standard_charge_percentage": 95.0000, "estimated_amount": 52049, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 41091.8, "standard_charge_percentage": 75.0000, "estimated_amount": 41091, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 20271.9, "standard_charge_percentage": 37.0000, "estimated_amount": 20271, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 15751.9, "estimated_amount": 15751, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 15751.9, "estimated_amount": 15751, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" }]}]} , { "description": "Hc Reposition Transvenous Pm/Electrode", "code_information": [ { "code": "33215", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9639, "discounted_cash": 3849,"minimum": 1032.58,"maximum": 9639,"payers_information":[{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3855.6, "standard_charge_percentage": 40.0000, "estimated_amount": 3855, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8434.13, "standard_charge_percentage": 87.5000, "estimated_amount": 8434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 9157.05, "standard_charge_percentage": 95.0000, "estimated_amount": 9157, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4819.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4819, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2891.7, "standard_charge_percentage": 30.0000, "estimated_amount": 2891, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7903.98, "standard_charge_percentage": 82.0000, "estimated_amount": 7903, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5397.84, "standard_charge_percentage": 56.0000, "estimated_amount": 5397, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5590.62, "standard_charge_percentage": 58.0000, "estimated_amount": 5590, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3566.43, "standard_charge_percentage": 37.0000, "estimated_amount": 3566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5783.4, "standard_charge_percentage": 60.0000, "estimated_amount": 5783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1032.58, "estimated_amount": 1032, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 8193.15, "standard_charge_percentage": 85.0000, "estimated_amount": 8193, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8434.13, "standard_charge_percentage": 87.5000, "estimated_amount": 8434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9639, "standard_charge_percentage": 100.0000, "estimated_amount": 9639, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9639, "standard_charge_percentage": 100.0000, "estimated_amount": 9639, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5783.4, "standard_charge_percentage": 60.0000, "estimated_amount": 5783, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9446.22, "standard_charge_percentage": 98.0000, "estimated_amount": 9446, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9639, "estimated_amount": 9639, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" }]}]} , { "description": "Hc Insrt Single Transven Electrod/Pm/Defib", "code_information": [ { "code": "33216", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 46470.5, "discounted_cash": 10120,"minimum": 3594.76,"maximum": 46470.5,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 3594.76, "estimated_amount": 3594, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 37176.4, "standard_charge_percentage": 80.0000, "estimated_amount": 37176, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 41823.4, "standard_charge_percentage": 90.0000, "estimated_amount": 41823, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 18588.2, "standard_charge_percentage": 40.0000, "estimated_amount": 18588, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 40661.7, "standard_charge_percentage": 87.5000, "estimated_amount": 40661, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 40661.7, "standard_charge_percentage": 87.5000, "estimated_amount": 40661, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 37176.4, "standard_charge_percentage": 80.0000, "estimated_amount": 37176, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 44147, "standard_charge_percentage": 95.0000, "estimated_amount": 44146, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 46470.5, "standard_charge_percentage": 100.0000, "estimated_amount": 46470, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 27882.3, "standard_charge_percentage": 60.0000, "estimated_amount": 27882, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 37176.4, "standard_charge_percentage": 80.0000, "estimated_amount": 37176, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 37176.4, "standard_charge_percentage": 80.0000, "estimated_amount": 37176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 13941.2, "standard_charge_percentage": 30.0000, "estimated_amount": 13941, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 32529.3, "standard_charge_percentage": 70.0000, "estimated_amount": 32529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 27882.3, "standard_charge_percentage": 60.0000, "estimated_amount": 27882, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 10159.4, "estimated_amount": 10159, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 39499.9, "standard_charge_percentage": 85.0000, "estimated_amount": 39499, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 37176.4, "standard_charge_percentage": 80.0000, "estimated_amount": 37176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 34852.9, "standard_charge_percentage": 75.0000, "estimated_amount": 34852, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 32529.3, "standard_charge_percentage": 70.0000, "estimated_amount": 32529, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 38105.8, "standard_charge_percentage": 82.0000, "estimated_amount": 38105, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 45541.1, "standard_charge_percentage": 98.0000, "estimated_amount": 45541, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 8183.99, "estimated_amount": 8183, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 10088.8, "estimated_amount": 10088, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 34852.9, "standard_charge_percentage": 75.0000, "estimated_amount": 34852, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 37176.4, "standard_charge_percentage": 80.0000, "estimated_amount": 37176, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 32529.3, "standard_charge_percentage": 70.0000, "estimated_amount": 32529, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 34852.9, "standard_charge_percentage": 75.0000, "estimated_amount": 34852, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 26023.5, "standard_charge_percentage": 56.0000, "estimated_amount": 26023, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 17194.1, "standard_charge_percentage": 37.0000, "estimated_amount": 17194, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 41823.4, "standard_charge_percentage": 90.0000, "estimated_amount": 41823, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 27567, "estimated_amount": 27566, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 10510.3, "estimated_amount": 10510, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 14402.9, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 15570.7, "estimated_amount": 15570, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 10229.9, "estimated_amount": 10229, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 34852.9, "standard_charge_percentage": 75.0000, "estimated_amount": 34852, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 37176.4, "standard_charge_percentage": 80.0000, "estimated_amount": 37176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 23235.3, "standard_charge_percentage": 50.0000, "estimated_amount": 23235, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 41823.4, "standard_charge_percentage": 90.0000, "estimated_amount": 41823, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 41823.4, "standard_charge_percentage": 90.0000, "estimated_amount": 41823, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 37176.4, "standard_charge_percentage": 80.0000, "estimated_amount": 37176, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 46470.5, "standard_charge_percentage": 100.0000, "estimated_amount": 46470, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 37176.4, "standard_charge_percentage": 80.0000, "estimated_amount": 37176, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 26952.9, "standard_charge_percentage": 58.0000, "estimated_amount": 26952, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 37176.4, "standard_charge_percentage": 80.0000, "estimated_amount": 37176, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 41823.4, "standard_charge_percentage": 90.0000, "estimated_amount": 41823, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 34852.9, "standard_charge_percentage": 75.0000, "estimated_amount": 34852, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 7941.08, "estimated_amount": 7941, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert 2 Transven Electrod/Pm/Defib", "code_information": [ { "code": "33217", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 45525, "discounted_cash": 10120,"minimum": 3594.76,"maximum": 45525,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 18210, "standard_charge_percentage": 40.0000, "estimated_amount": 18210, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 13657.5, "standard_charge_percentage": 30.0000, "estimated_amount": 13657, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 15570.7, "estimated_amount": 15570, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 10159.4, "estimated_amount": 10159, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 8183.99, "estimated_amount": 8183, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 22762.5, "standard_charge_percentage": 50.0000, "estimated_amount": 22762, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 27315, "standard_charge_percentage": 60.0000, "estimated_amount": 27315, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 44614.5, "standard_charge_percentage": 98.0000, "estimated_amount": 44614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 27315, "standard_charge_percentage": 60.0000, "estimated_amount": 27315, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 27567, "estimated_amount": 27566, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 14402.9, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 3594.76, "estimated_amount": 3594, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 10088.8, "estimated_amount": 10088, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 39834.4, "standard_charge_percentage": 87.5000, "estimated_amount": 39834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 45525, "standard_charge_percentage": 100.0000, "estimated_amount": 45525, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 45525, "standard_charge_percentage": 100.0000, "estimated_amount": 45525, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 25494, "standard_charge_percentage": 56.0000, "estimated_amount": 25494, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 26404.5, "standard_charge_percentage": 58.0000, "estimated_amount": 26404, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 16844.3, "standard_charge_percentage": 37.0000, "estimated_amount": 16844, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 7941.08, "estimated_amount": 7941, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 10510.3, "estimated_amount": 10510, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 10229.9, "estimated_amount": 10229, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 38696.3, "standard_charge_percentage": 85.0000, "estimated_amount": 38696, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 39834.4, "standard_charge_percentage": 87.5000, "estimated_amount": 39834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 43248.8, "standard_charge_percentage": 95.0000, "estimated_amount": 43248, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 31867.5, "standard_charge_percentage": 70.0000, "estimated_amount": 31867, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 31867.5, "standard_charge_percentage": 70.0000, "estimated_amount": 31867, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 31867.5, "standard_charge_percentage": 70.0000, "estimated_amount": 31867, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 37330.5, "standard_charge_percentage": 82.0000, "estimated_amount": 37330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" }]}]} , { "description": "Hc Relocate Skin Pocket For Pacemaker", "code_information": [ { "code": "33222", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1777.22, "discounted_cash": 2237,"minimum": 533.17,"maximum": 1777.22,"payers_information":[{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1332.91, "standard_charge_percentage": 75.0000, "estimated_amount": 1332, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1510.64, "standard_charge_percentage": 85.0000, "estimated_amount": 1510, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1555.07, "standard_charge_percentage": 87.5000, "estimated_amount": 1555, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1421.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1421.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1332.91, "standard_charge_percentage": 75.0000, "estimated_amount": 1332, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 995.24, "standard_charge_percentage": 56.0000, "estimated_amount": 995, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1599.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1599, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1755.21, "estimated_amount": 1755, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1421.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1555.07, "standard_charge_percentage": 87.5000, "estimated_amount": 1555, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1688.36, "standard_charge_percentage": 95.0000, "estimated_amount": 1688, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1066.33, "standard_charge_percentage": 60.0000, "estimated_amount": 1066, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1421.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1244.05, "standard_charge_percentage": 70.0000, "estimated_amount": 1244, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1244.05, "standard_charge_percentage": 70.0000, "estimated_amount": 1244, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1332.91, "standard_charge_percentage": 75.0000, "estimated_amount": 1332, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1421.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1332.91, "standard_charge_percentage": 75.0000, "estimated_amount": 1332, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1066.33, "standard_charge_percentage": 60.0000, "estimated_amount": 1066, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1421.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1599.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1599, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1599.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1599, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 710.89, "standard_charge_percentage": 40.0000, "estimated_amount": 710, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1777.22, "standard_charge_percentage": 100.0000, "estimated_amount": 1777, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 533.17, "standard_charge_percentage": 30.0000, "estimated_amount": 533, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1457.32, "standard_charge_percentage": 82.0000, "estimated_amount": 1457, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1599.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1599, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1741.68, "standard_charge_percentage": 98.0000, "estimated_amount": 1741, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1730.35, "estimated_amount": 1730, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 590.76, "estimated_amount": 590, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1332.91, "standard_charge_percentage": 75.0000, "estimated_amount": 1332, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 888.61, "standard_charge_percentage": 50.0000, "estimated_amount": 888, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1599.5, "standard_charge_percentage": 90.0000, "estimated_amount": 1599, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1421.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1421.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1777.22, "standard_charge_percentage": 100.0000, "estimated_amount": 1777, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1421.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1421.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1244.05, "standard_charge_percentage": 70.0000, "estimated_amount": 1244, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1030.79, "standard_charge_percentage": 58.0000, "estimated_amount": 1030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1777.22, "estimated_amount": 1777, "methodology": "fee schedule" }]}]} , { "description": "Hc Relocate Skin Pocket Cardioverter Defib", "code_information": [ { "code": "33223", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9419.85, "discounted_cash": 2237,"minimum": 590.76,"maximum": 9419.85,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2245.51, "estimated_amount": 2245, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 590.76, "estimated_amount": 590, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7535.88, "standard_charge_percentage": 80.0000, "estimated_amount": 7535, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8477.86, "standard_charge_percentage": 90.0000, "estimated_amount": 8477, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7535.88, "standard_charge_percentage": 80.0000, "estimated_amount": 7535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9419.85, "standard_charge_percentage": 100.0000, "estimated_amount": 9419, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7724.28, "standard_charge_percentage": 82.0000, "estimated_amount": 7724, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5275.12, "standard_charge_percentage": 56.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5463.51, "standard_charge_percentage": 58.0000, "estimated_amount": 5463, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8477.86, "standard_charge_percentage": 90.0000, "estimated_amount": 8477, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9231.45, "standard_charge_percentage": 98.0000, "estimated_amount": 9231, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7064.89, "standard_charge_percentage": 75.0000, "estimated_amount": 7064, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3183.46, "estimated_amount": 3183, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3441.58, "estimated_amount": 3441, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7064.89, "standard_charge_percentage": 75.0000, "estimated_amount": 7064, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7535.88, "standard_charge_percentage": 80.0000, "estimated_amount": 7535, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8477.86, "standard_charge_percentage": 90.0000, "estimated_amount": 8477, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8242.37, "standard_charge_percentage": 87.5000, "estimated_amount": 8242, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7535.88, "standard_charge_percentage": 80.0000, "estimated_amount": 7535, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7535.88, "standard_charge_percentage": 80.0000, "estimated_amount": 7535, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7535.88, "standard_charge_percentage": 80.0000, "estimated_amount": 7535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7064.89, "standard_charge_percentage": 75.0000, "estimated_amount": 7064, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6593.9, "standard_charge_percentage": 70.0000, "estimated_amount": 6593, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6593.9, "standard_charge_percentage": 70.0000, "estimated_amount": 6593, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5651.91, "standard_charge_percentage": 60.0000, "estimated_amount": 5651, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1730.35, "estimated_amount": 1730, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2261.1, "estimated_amount": 2261, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7064.89, "standard_charge_percentage": 75.0000, "estimated_amount": 7064, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4709.93, "standard_charge_percentage": 50.0000, "estimated_amount": 4709, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8477.86, "standard_charge_percentage": 90.0000, "estimated_amount": 8477, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 8006.87, "standard_charge_percentage": 85.0000, "estimated_amount": 8006, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3767.94, "standard_charge_percentage": 40.0000, "estimated_amount": 3767, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7535.88, "standard_charge_percentage": 80.0000, "estimated_amount": 7535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9419.85, "standard_charge_percentage": 100.0000, "estimated_amount": 9419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2825.95, "standard_charge_percentage": 30.0000, "estimated_amount": 2825, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7535.88, "standard_charge_percentage": 80.0000, "estimated_amount": 7535, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8477.86, "standard_charge_percentage": 90.0000, "estimated_amount": 8477, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1755.21, "estimated_amount": 1755, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2753.26, "estimated_amount": 2753, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1559.38, "estimated_amount": 1559, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 2229.91, "estimated_amount": 2229, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8242.37, "standard_charge_percentage": 87.5000, "estimated_amount": 8242, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7535.88, "standard_charge_percentage": 80.0000, "estimated_amount": 7535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8948.86, "standard_charge_percentage": 95.0000, "estimated_amount": 8948, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5651.91, "standard_charge_percentage": 60.0000, "estimated_amount": 5651, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7535.88, "standard_charge_percentage": 80.0000, "estimated_amount": 7535, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6593.9, "standard_charge_percentage": 70.0000, "estimated_amount": 6593, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7064.89, "standard_charge_percentage": 75.0000, "estimated_amount": 7064, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2409.11, "estimated_amount": 2409, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 6093.09, "estimated_amount": 6093, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1806.83, "estimated_amount": 1806, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2323.07, "estimated_amount": 2323, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1720.79, "estimated_amount": 1720, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Lv Pacing Elect To Existing Pm/Defib", "code_information": [ { "code": "33224", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 58020.1, "discounted_cash": 12798,"minimum": 3130,"maximum": 58020.1,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 43515.1, "standard_charge_percentage": 75.0000, "estimated_amount": 43515, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 46416.1, "standard_charge_percentage": 80.0000, "estimated_amount": 46416, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 43515.1, "standard_charge_percentage": 75.0000, "estimated_amount": 43515, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 49317.1, "standard_charge_percentage": 85.0000, "estimated_amount": 49317, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 34812.1, "standard_charge_percentage": 60.0000, "estimated_amount": 34812, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 17406, "standard_charge_percentage": 30.0000, "estimated_amount": 17406, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 40614.1, "standard_charge_percentage": 70.0000, "estimated_amount": 40614, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 43515.1, "standard_charge_percentage": 75.0000, "estimated_amount": 43515, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 21467.4, "standard_charge_percentage": 37.0000, "estimated_amount": 21467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 46416.1, "standard_charge_percentage": 80.0000, "estimated_amount": 46416, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 52218.1, "standard_charge_percentage": 90.0000, "estimated_amount": 52218, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 52218.1, "standard_charge_percentage": 90.0000, "estimated_amount": 52218, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 56859.7, "standard_charge_percentage": 98.0000, "estimated_amount": 56859, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 34812.1, "standard_charge_percentage": 60.0000, "estimated_amount": 34812, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 10337.2, "estimated_amount": 10337, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10355.6, "estimated_amount": 10355, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 12757.7, "estimated_amount": 12757, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 29010, "standard_charge_percentage": 50.0000, "estimated_amount": 29010, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 52218.1, "standard_charge_percentage": 90.0000, "estimated_amount": 52218, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 52218.1, "standard_charge_percentage": 90.0000, "estimated_amount": 52218, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 23208, "standard_charge_percentage": 40.0000, "estimated_amount": 23208, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 50767.6, "standard_charge_percentage": 87.5000, "estimated_amount": 50767, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 58020.1, "standard_charge_percentage": 100.0000, "estimated_amount": 58020, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 58020.1, "standard_charge_percentage": 100.0000, "estimated_amount": 58020, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 46416.1, "standard_charge_percentage": 80.0000, "estimated_amount": 46416, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 46416.1, "standard_charge_percentage": 80.0000, "estimated_amount": 46416, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 46416.1, "standard_charge_percentage": 80.0000, "estimated_amount": 46416, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 43515.1, "standard_charge_percentage": 75.0000, "estimated_amount": 43515, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 43515.1, "standard_charge_percentage": 75.0000, "estimated_amount": 43515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 15751.9, "estimated_amount": 15751, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 12847, "estimated_amount": 12846, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 8921.5, "estimated_amount": 8921, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 46416.1, "standard_charge_percentage": 80.0000, "estimated_amount": 46416, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 46416.1, "standard_charge_percentage": 80.0000, "estimated_amount": 46416, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 46416.1, "standard_charge_percentage": 80.0000, "estimated_amount": 46416, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 55119.1, "standard_charge_percentage": 95.0000, "estimated_amount": 55119, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 46416.1, "standard_charge_percentage": 80.0000, "estimated_amount": 46416, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 32491.3, "standard_charge_percentage": 56.0000, "estimated_amount": 32491, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 13782.9, "estimated_amount": 13782, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 34859.6, "estimated_amount": 34859, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 13290.7, "estimated_amount": 13290, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 10337.2, "estimated_amount": 10337, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 18213.1, "estimated_amount": 18213, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 8921.5, "estimated_amount": 8921, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 12936.2, "estimated_amount": 12936, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 52218.1, "standard_charge_percentage": 90.0000, "estimated_amount": 52218, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 50767.6, "standard_charge_percentage": 87.5000, "estimated_amount": 50767, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 46416.1, "standard_charge_percentage": 80.0000, "estimated_amount": 46416, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 40614.1, "standard_charge_percentage": 70.0000, "estimated_amount": 40614, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 40614.1, "standard_charge_percentage": 70.0000, "estimated_amount": 40614, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 47576.5, "standard_charge_percentage": 82.0000, "estimated_amount": 47576, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 33651.7, "standard_charge_percentage": 58.0000, "estimated_amount": 33651, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10041.8, "estimated_amount": 10041, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 15751.9, "estimated_amount": 15751, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 13782.9, "estimated_amount": 13782, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 19689.9, "estimated_amount": 19689, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Lv Pacing Elect To New Pm/Defib", "code_information": [ { "code": "33225", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 35288.7,"minimum": 501.9,"maximum": 35288.7,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 26466.5, "standard_charge_percentage": 75.0000, "estimated_amount": 26466, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 28231, "standard_charge_percentage": 80.0000, "estimated_amount": 28230, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 28231, "standard_charge_percentage": 80.0000, "estimated_amount": 28230, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 35288.7, "standard_charge_percentage": 100.0000, "estimated_amount": 35288, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 33524.3, "standard_charge_percentage": 95.0000, "estimated_amount": 33524, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 28231, "standard_charge_percentage": 80.0000, "estimated_amount": 28230, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10586.6, "standard_charge_percentage": 30.0000, "estimated_amount": 10586, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 24702.1, "standard_charge_percentage": 70.0000, "estimated_amount": 24702, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 34582.9, "standard_charge_percentage": 98.0000, "estimated_amount": 34582, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 21173.2, "standard_charge_percentage": 60.0000, "estimated_amount": 21173, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 26466.5, "standard_charge_percentage": 75.0000, "estimated_amount": 26466, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 17644.3, "standard_charge_percentage": 50.0000, "estimated_amount": 17644, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 31759.8, "standard_charge_percentage": 90.0000, "estimated_amount": 31759, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 31759.8, "standard_charge_percentage": 90.0000, "estimated_amount": 31759, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 21173.2, "standard_charge_percentage": 60.0000, "estimated_amount": 21173, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 28231, "standard_charge_percentage": 80.0000, "estimated_amount": 28230, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 26466.5, "standard_charge_percentage": 75.0000, "estimated_amount": 26466, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 24702.1, "standard_charge_percentage": 70.0000, "estimated_amount": 24702, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 28936.7, "standard_charge_percentage": 82.0000, "estimated_amount": 28936, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 19761.7, "standard_charge_percentage": 56.0000, "estimated_amount": 19761, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 20467.5, "standard_charge_percentage": 58.0000, "estimated_amount": 20467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 28231, "standard_charge_percentage": 80.0000, "estimated_amount": 28230, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 29995.4, "standard_charge_percentage": 85.0000, "estimated_amount": 29995, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 14115.5, "standard_charge_percentage": 40.0000, "estimated_amount": 14115, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 30877.6, "standard_charge_percentage": 87.5000, "estimated_amount": 30877, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 30877.6, "standard_charge_percentage": 87.5000, "estimated_amount": 30877, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 35288.7, "standard_charge_percentage": 100.0000, "estimated_amount": 35288, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 28231, "standard_charge_percentage": 80.0000, "estimated_amount": 28230, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 28231, "standard_charge_percentage": 80.0000, "estimated_amount": 28230, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 24702.1, "standard_charge_percentage": 70.0000, "estimated_amount": 24702, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 31759.8, "standard_charge_percentage": 90.0000, "estimated_amount": 31759, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 501.9, "estimated_amount": 501, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 28231, "standard_charge_percentage": 80.0000, "estimated_amount": 28230, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 31759.8, "standard_charge_percentage": 90.0000, "estimated_amount": 31759, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 28231, "standard_charge_percentage": 80.0000, "estimated_amount": 28230, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 26466.5, "standard_charge_percentage": 75.0000, "estimated_amount": 26466, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 13056.8, "standard_charge_percentage": 37.0000, "estimated_amount": 13056, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 28231, "standard_charge_percentage": 80.0000, "estimated_amount": 28230, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 31759.8, "standard_charge_percentage": 90.0000, "estimated_amount": 31759, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 26466.5, "standard_charge_percentage": 75.0000, "estimated_amount": 26466, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Remvl Perm Pm Plse Gen W/Repl Plse Gen Sngl Ld", "code_information": [ { "code": "33227", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 27014.7, "discounted_cash": 10120,"minimum": 3130,"maximum": 27014.7,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4458.83, "estimated_amount": 4458, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 20261, "standard_charge_percentage": 75.0000, "estimated_amount": 20261, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 21611.8, "standard_charge_percentage": 80.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 24313.2, "standard_charge_percentage": 90.0000, "estimated_amount": 24313, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 10805.9, "standard_charge_percentage": 40.0000, "estimated_amount": 10805, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 25664, "standard_charge_percentage": 95.0000, "estimated_amount": 25663, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 27014.7, "standard_charge_percentage": 100.0000, "estimated_amount": 27014, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 21611.8, "standard_charge_percentage": 80.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 18910.3, "standard_charge_percentage": 70.0000, "estimated_amount": 18910, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 7941.08, "estimated_amount": 7941, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 15570.7, "estimated_amount": 15570, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 10229.9, "estimated_amount": 10229, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 20261, "standard_charge_percentage": 75.0000, "estimated_amount": 20261, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 24313.2, "standard_charge_percentage": 90.0000, "estimated_amount": 24313, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 22962.5, "standard_charge_percentage": 85.0000, "estimated_amount": 22962, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 23637.9, "standard_charge_percentage": 87.5000, "estimated_amount": 23637, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 21611.8, "standard_charge_percentage": 80.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 16208.8, "standard_charge_percentage": 60.0000, "estimated_amount": 16208, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 21611.8, "standard_charge_percentage": 80.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 8104.41, "standard_charge_percentage": 30.0000, "estimated_amount": 8104, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 15668.5, "standard_charge_percentage": 58.0000, "estimated_amount": 15668, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 24313.2, "standard_charge_percentage": 90.0000, "estimated_amount": 24313, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 26474.4, "standard_charge_percentage": 98.0000, "estimated_amount": 26474, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 14402.9, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 10159.4, "estimated_amount": 10159, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 13507.4, "standard_charge_percentage": 50.0000, "estimated_amount": 13507, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 21611.8, "standard_charge_percentage": 80.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 20261, "standard_charge_percentage": 75.0000, "estimated_amount": 20261, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 18910.3, "standard_charge_percentage": 70.0000, "estimated_amount": 18910, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 24313.2, "standard_charge_percentage": 90.0000, "estimated_amount": 24313, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 20261, "standard_charge_percentage": 75.0000, "estimated_amount": 20261, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 27014.7, "estimated_amount": 27014, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 10510.3, "estimated_amount": 10510, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 8183.99, "estimated_amount": 8183, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 10088.8, "estimated_amount": 10088, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 21611.8, "standard_charge_percentage": 80.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 24313.2, "standard_charge_percentage": 90.0000, "estimated_amount": 24313, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 23637.9, "standard_charge_percentage": 87.5000, "estimated_amount": 23637, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 21611.8, "standard_charge_percentage": 80.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 21611.8, "standard_charge_percentage": 80.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 27014.7, "standard_charge_percentage": 100.0000, "estimated_amount": 27014, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 21611.8, "standard_charge_percentage": 80.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 18910.3, "standard_charge_percentage": 70.0000, "estimated_amount": 18910, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 20261, "standard_charge_percentage": 75.0000, "estimated_amount": 20261, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 22152, "standard_charge_percentage": 82.0000, "estimated_amount": 22152, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 15128.2, "standard_charge_percentage": 56.0000, "estimated_amount": 15128, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 9995.44, "standard_charge_percentage": 37.0000, "estimated_amount": 9995, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 21611.8, "standard_charge_percentage": 80.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 16208.8, "standard_charge_percentage": 60.0000, "estimated_amount": 16208, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" }]}]} , { "description": "Hc Remvl Perm Pm Pls Gen W/Repl Plse Gen 2 Ld Sys", "code_information": [ { "code": "33228", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 35567.1, "discounted_cash": 12798,"minimum": 3130,"maximum": 35567.1,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 8921.5, "estimated_amount": 8921, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10355.6, "estimated_amount": 10355, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 8921.5, "estimated_amount": 8921, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 30232, "standard_charge_percentage": 85.0000, "estimated_amount": 30232, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 31121.2, "standard_charge_percentage": 87.5000, "estimated_amount": 31121, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 35567.1, "standard_charge_percentage": 100.0000, "estimated_amount": 35567, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 20628.9, "standard_charge_percentage": 58.0000, "estimated_amount": 20628, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 21340.3, "standard_charge_percentage": 60.0000, "estimated_amount": 21340, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 15751.9, "estimated_amount": 15751, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4886.73, "estimated_amount": 4886, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 12936.2, "estimated_amount": 12936, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 14226.8, "standard_charge_percentage": 40.0000, "estimated_amount": 14226, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10670.1, "standard_charge_percentage": 30.0000, "estimated_amount": 10670, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 29165, "standard_charge_percentage": 82.0000, "estimated_amount": 29165, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 19917.6, "standard_charge_percentage": 56.0000, "estimated_amount": 19917, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 13159.8, "standard_charge_percentage": 37.0000, "estimated_amount": 13159, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 34859.6, "estimated_amount": 34859, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 10337.2, "estimated_amount": 10337, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 12757.7, "estimated_amount": 12757, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 17783.5, "standard_charge_percentage": 50.0000, "estimated_amount": 17783, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 31121.2, "standard_charge_percentage": 87.5000, "estimated_amount": 31121, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 35567.1, "standard_charge_percentage": 100.0000, "estimated_amount": 35567, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 33788.8, "standard_charge_percentage": 95.0000, "estimated_amount": 33788, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 21340.3, "standard_charge_percentage": 60.0000, "estimated_amount": 21340, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 24897, "standard_charge_percentage": 70.0000, "estimated_amount": 24896, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 34855.8, "standard_charge_percentage": 98.0000, "estimated_amount": 34855, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 13782.9, "estimated_amount": 13782, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 13290.7, "estimated_amount": 13290, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 10337.2, "estimated_amount": 10337, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 18213.1, "estimated_amount": 18213, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 12847, "estimated_amount": 12846, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 28453.7, "standard_charge_percentage": 80.0000, "estimated_amount": 28453, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 24897, "standard_charge_percentage": 70.0000, "estimated_amount": 24896, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 24897, "standard_charge_percentage": 70.0000, "estimated_amount": 24896, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 32010.4, "standard_charge_percentage": 90.0000, "estimated_amount": 32010, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 26675.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26675, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 9844.94, "estimated_amount": 9844, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10041.8, "estimated_amount": 10041, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 15751.9, "estimated_amount": 15751, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 13782.9, "estimated_amount": 13782, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 19689.9, "estimated_amount": 19689, "methodology": "fee schedule" }]}]} , { "description": "Hc Remvl Perm Pm Pls Gen W/Repl Plse Gen Mult Ld Sys", "code_information": [ { "code": "33229", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 64504.8, "discounted_cash": 23322,"minimum": 3130,"maximum": 64504.8,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 23411.3, "estimated_amount": 23411, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4886.73, "estimated_amount": 4886, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 48378.6, "standard_charge_percentage": 75.0000, "estimated_amount": 48378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 32252.4, "standard_charge_percentage": 50.0000, "estimated_amount": 32252, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 25801.9, "standard_charge_percentage": 40.0000, "estimated_amount": 25801, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 51603.8, "standard_charge_percentage": 80.0000, "estimated_amount": 51603, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 64504.8, "standard_charge_percentage": 100.0000, "estimated_amount": 64504, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 38702.9, "standard_charge_percentage": 60.0000, "estimated_amount": 38702, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 51603.8, "standard_charge_percentage": 80.0000, "estimated_amount": 51603, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 45153.4, "standard_charge_percentage": 70.0000, "estimated_amount": 45153, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 45153.4, "standard_charge_percentage": 70.0000, "estimated_amount": 45153, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 52893.9, "standard_charge_percentage": 82.0000, "estimated_amount": 52893, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 23866.8, "standard_charge_percentage": 37.0000, "estimated_amount": 23866, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 48378.6, "standard_charge_percentage": 75.0000, "estimated_amount": 48378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 38702.9, "standard_charge_percentage": 60.0000, "estimated_amount": 38702, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 17940.6, "estimated_amount": 17940, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 17940.6, "estimated_amount": 17940, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 28705, "estimated_amount": 28704, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 28705, "estimated_amount": 28704, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 17940.6, "estimated_amount": 17940, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 35881.2, "estimated_amount": 35881, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 16257.8, "estimated_amount": 16257, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 51603.8, "standard_charge_percentage": 80.0000, "estimated_amount": 51603, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 58054.3, "standard_charge_percentage": 90.0000, "estimated_amount": 58054, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 54829.1, "standard_charge_percentage": 85.0000, "estimated_amount": 54829, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 19351.4, "standard_charge_percentage": 30.0000, "estimated_amount": 19351, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 48378.6, "standard_charge_percentage": 75.0000, "estimated_amount": 48378, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 45153.4, "standard_charge_percentage": 70.0000, "estimated_amount": 45153, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 48378.6, "standard_charge_percentage": 75.0000, "estimated_amount": 48378, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 17940.6, "estimated_amount": 17940, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 17940.6, "estimated_amount": 17940, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 18837.7, "estimated_amount": 18837, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 18299.4, "estimated_amount": 18299, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 17940.6, "estimated_amount": 17940, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 33190.2, "estimated_amount": 33190, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 23248.7, "estimated_amount": 23248, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 56441.7, "standard_charge_percentage": 87.5000, "estimated_amount": 56441, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 51603.8, "standard_charge_percentage": 80.0000, "estimated_amount": 51603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 51603.8, "standard_charge_percentage": 80.0000, "estimated_amount": 51603, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 51603.8, "standard_charge_percentage": 80.0000, "estimated_amount": 51603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 51603.8, "standard_charge_percentage": 80.0000, "estimated_amount": 51603, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 58054.3, "standard_charge_percentage": 90.0000, "estimated_amount": 58054, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 58054.3, "standard_charge_percentage": 90.0000, "estimated_amount": 58054, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 17940.6, "estimated_amount": 17940, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 25116.9, "estimated_amount": 25116, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 63525.3, "estimated_amount": 63525, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 17940.6, "estimated_amount": 17940, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 18837.7, "estimated_amount": 18837, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 25116.9, "estimated_amount": 25116, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 17940.6, "estimated_amount": 17940, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 18720.5, "estimated_amount": 18720, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 16257.8, "estimated_amount": 16257, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 23573.8, "estimated_amount": 23573, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 48378.6, "standard_charge_percentage": 75.0000, "estimated_amount": 48378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 51603.8, "standard_charge_percentage": 80.0000, "estimated_amount": 51603, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 58054.3, "standard_charge_percentage": 90.0000, "estimated_amount": 58054, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 58054.3, "standard_charge_percentage": 90.0000, "estimated_amount": 58054, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 56441.7, "standard_charge_percentage": 87.5000, "estimated_amount": 56441, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 51603.8, "standard_charge_percentage": 80.0000, "estimated_amount": 51603, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 61279.6, "standard_charge_percentage": 95.0000, "estimated_amount": 61279, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 64504.8, "standard_charge_percentage": 100.0000, "estimated_amount": 64504, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 51603.8, "standard_charge_percentage": 80.0000, "estimated_amount": 51603, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 36122.7, "standard_charge_percentage": 56.0000, "estimated_amount": 36122, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 37412.8, "standard_charge_percentage": 58.0000, "estimated_amount": 37412, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 63214.7, "standard_charge_percentage": 98.0000, "estimated_amount": 63214, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 17940.6, "estimated_amount": 17940, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 24219.8, "estimated_amount": 24219, "methodology": "fee schedule" }]}]} , { "description": "Hc Remv Perm Pacer Generator", "code_information": [ { "code": "33233", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 45525, "discounted_cash": 10120,"minimum": 898,"maximum": 45525,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2752.17, "estimated_amount": 2752, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 10229.9, "estimated_amount": 10229, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 38696.3, "standard_charge_percentage": 85.0000, "estimated_amount": 38696, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 43248.8, "standard_charge_percentage": 95.0000, "estimated_amount": 43248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 31867.5, "standard_charge_percentage": 70.0000, "estimated_amount": 31867, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 26404.5, "standard_charge_percentage": 58.0000, "estimated_amount": 26404, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 15570.7, "estimated_amount": 15570, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 39834.4, "standard_charge_percentage": 87.5000, "estimated_amount": 39834, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 31867.5, "standard_charge_percentage": 70.0000, "estimated_amount": 31867, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 25494, "standard_charge_percentage": 56.0000, "estimated_amount": 25494, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 27315, "standard_charge_percentage": 60.0000, "estimated_amount": 27315, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 14402.9, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 10159.4, "estimated_amount": 10159, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 22762.5, "standard_charge_percentage": 50.0000, "estimated_amount": 22762, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 45525, "standard_charge_percentage": 100.0000, "estimated_amount": 45525, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 27315, "standard_charge_percentage": 60.0000, "estimated_amount": 27315, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 13657.5, "standard_charge_percentage": 30.0000, "estimated_amount": 13657, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 31867.5, "standard_charge_percentage": 70.0000, "estimated_amount": 31867, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 8183.99, "estimated_amount": 8183, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 10088.8, "estimated_amount": 10088, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 18210, "standard_charge_percentage": 40.0000, "estimated_amount": 18210, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 39834.4, "standard_charge_percentage": 87.5000, "estimated_amount": 39834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 45525, "standard_charge_percentage": 100.0000, "estimated_amount": 45525, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 37330.5, "standard_charge_percentage": 82.0000, "estimated_amount": 37330, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 44614.5, "standard_charge_percentage": 98.0000, "estimated_amount": 44614, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 27567, "estimated_amount": 27566, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 7941.08, "estimated_amount": 7941, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 10510.3, "estimated_amount": 10510, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" }]}]} , { "description": "Hc Remv Transven Pacer Electrode,2 Lead", "code_information": [ { "code": "33235", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19269.3, "discounted_cash": 4450,"minimum": 1272.15,"maximum": 19269.3,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 14452, "standard_charge_percentage": 75.0000, "estimated_amount": 14451, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 17342.4, "standard_charge_percentage": 90.0000, "estimated_amount": 17342, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 16860.6, "standard_charge_percentage": 87.5000, "estimated_amount": 16860, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 15415.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15415, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 18305.8, "standard_charge_percentage": 95.0000, "estimated_amount": 18305, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 19269.3, "standard_charge_percentage": 100.0000, "estimated_amount": 19269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5780.79, "standard_charge_percentage": 30.0000, "estimated_amount": 5780, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 13488.5, "standard_charge_percentage": 70.0000, "estimated_amount": 13488, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10790.8, "standard_charge_percentage": 56.0000, "estimated_amount": 10790, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 11176.2, "standard_charge_percentage": 58.0000, "estimated_amount": 11176, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 7129.64, "standard_charge_percentage": 37.0000, "estimated_amount": 7129, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4792.98, "estimated_amount": 4792, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 12122.4, "estimated_amount": 12122, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3594.74, "estimated_amount": 3594, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3492.03, "estimated_amount": 3492, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3594.74, "estimated_amount": 3594, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4792.98, "estimated_amount": 4792, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 5477.7, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4467.5, "estimated_amount": 4467, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 3359.64, "estimated_amount": 3359, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 15415.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15415.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15415, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7707.72, "standard_charge_percentage": 40.0000, "estimated_amount": 7707, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 15415.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15415, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 19269.3, "standard_charge_percentage": 100.0000, "estimated_amount": 19269, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15415.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15415, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 17342.4, "standard_charge_percentage": 90.0000, "estimated_amount": 17342, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1272.15, "estimated_amount": 1272, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4436.47, "estimated_amount": 4436, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 16860.6, "standard_charge_percentage": 87.5000, "estimated_amount": 16860, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15415.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15415, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 15415.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15415, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 15415.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15415, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 15800.8, "standard_charge_percentage": 82.0000, "estimated_amount": 15800, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 18883.9, "standard_charge_percentage": 98.0000, "estimated_amount": 18883, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4621.81, "estimated_amount": 4621, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 6333.59, "estimated_amount": 6333, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 3102.43, "estimated_amount": 3102, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 3102.43, "estimated_amount": 3102, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4498.52, "estimated_amount": 4498, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 14452, "standard_charge_percentage": 75.0000, "estimated_amount": 14451, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9634.65, "standard_charge_percentage": 50.0000, "estimated_amount": 9634, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 17342.4, "standard_charge_percentage": 90.0000, "estimated_amount": 17342, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 17342.4, "standard_charge_percentage": 90.0000, "estimated_amount": 17342, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 16378.9, "standard_charge_percentage": 85.0000, "estimated_amount": 16378, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 15415.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15415, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 11561.6, "standard_charge_percentage": 60.0000, "estimated_amount": 11561, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 15415.4, "standard_charge_percentage": 80.0000, "estimated_amount": 15415, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 14452, "standard_charge_percentage": 75.0000, "estimated_amount": 14451, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 13488.5, "standard_charge_percentage": 70.0000, "estimated_amount": 13488, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 13488.5, "standard_charge_percentage": 70.0000, "estimated_amount": 13488, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 14452, "standard_charge_percentage": 75.0000, "estimated_amount": 14451, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 17342.4, "standard_charge_percentage": 90.0000, "estimated_amount": 17342, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 14452, "standard_charge_percentage": 75.0000, "estimated_amount": 14451, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 11561.6, "standard_charge_percentage": 60.0000, "estimated_amount": 11561, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 5477.7, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6847.12, "estimated_amount": 6847, "methodology": "fee schedule" }]}]} , { "description": "Hc Rmv Pulse Generator,Sngl/Dual", "code_information": [ { "code": "33241", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 19214.6, "discounted_cash": 4450,"minimum": 3102.43,"maximum": 19214.6,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 17293.1, "standard_charge_percentage": 90.0000, "estimated_amount": 17293, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 19214.6, "standard_charge_percentage": 100.0000, "estimated_amount": 19214, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 14411, "standard_charge_percentage": 75.0000, "estimated_amount": 14410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 15371.7, "standard_charge_percentage": 80.0000, "estimated_amount": 15371, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 18830.3, "standard_charge_percentage": 98.0000, "estimated_amount": 18830, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4792.98, "estimated_amount": 4792, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 6333.59, "estimated_amount": 6333, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 5477.7, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 6847.12, "estimated_amount": 6847, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4467.5, "estimated_amount": 4467, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 3102.43, "estimated_amount": 3102, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 15371.7, "standard_charge_percentage": 80.0000, "estimated_amount": 15371, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 16332.4, "standard_charge_percentage": 85.0000, "estimated_amount": 16332, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 11528.8, "standard_charge_percentage": 60.0000, "estimated_amount": 11528, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 15371.7, "standard_charge_percentage": 80.0000, "estimated_amount": 15371, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 15371.7, "standard_charge_percentage": 80.0000, "estimated_amount": 15371, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 15371.7, "standard_charge_percentage": 80.0000, "estimated_amount": 15371, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 15371.7, "standard_charge_percentage": 80.0000, "estimated_amount": 15371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 14411, "standard_charge_percentage": 75.0000, "estimated_amount": 14410, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 13450.2, "standard_charge_percentage": 70.0000, "estimated_amount": 13450, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 11144.5, "standard_charge_percentage": 58.0000, "estimated_amount": 11144, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 17293.1, "standard_charge_percentage": 90.0000, "estimated_amount": 17293, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 14411, "standard_charge_percentage": 75.0000, "estimated_amount": 14410, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 3359.64, "estimated_amount": 3359, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 3102.43, "estimated_amount": 3102, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4498.52, "estimated_amount": 4498, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 14411, "standard_charge_percentage": 75.0000, "estimated_amount": 14410, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9607.3, "standard_charge_percentage": 50.0000, "estimated_amount": 9607, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 16812.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16812, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 16812.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16812, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 15371.7, "standard_charge_percentage": 80.0000, "estimated_amount": 15371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5764.38, "standard_charge_percentage": 30.0000, "estimated_amount": 5764, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 13450.2, "standard_charge_percentage": 70.0000, "estimated_amount": 13450, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 13450.2, "standard_charge_percentage": 70.0000, "estimated_amount": 13450, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 15756, "standard_charge_percentage": 82.0000, "estimated_amount": 15755, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10760.2, "standard_charge_percentage": 56.0000, "estimated_amount": 10760, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 7109.4, "standard_charge_percentage": 37.0000, "estimated_amount": 7109, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 17293.1, "standard_charge_percentage": 90.0000, "estimated_amount": 17293, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 11528.8, "standard_charge_percentage": 60.0000, "estimated_amount": 11528, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4792.98, "estimated_amount": 4792, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 12122.4, "estimated_amount": 12122, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3594.74, "estimated_amount": 3594, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 5477.7, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4436.47, "estimated_amount": 4436, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 15371.7, "standard_charge_percentage": 80.0000, "estimated_amount": 15371, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 14411, "standard_charge_percentage": 75.0000, "estimated_amount": 14410, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 17293.1, "standard_charge_percentage": 90.0000, "estimated_amount": 17293, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 17293.1, "standard_charge_percentage": 90.0000, "estimated_amount": 17293, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7685.84, "standard_charge_percentage": 40.0000, "estimated_amount": 7685, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 15371.7, "standard_charge_percentage": 80.0000, "estimated_amount": 15371, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 15371.7, "standard_charge_percentage": 80.0000, "estimated_amount": 15371, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 19214.6, "standard_charge_percentage": 100.0000, "estimated_amount": 19214, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 18253.9, "standard_charge_percentage": 95.0000, "estimated_amount": 18253, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3492.03, "estimated_amount": 3492, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4621.81, "estimated_amount": 4621, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3594.74, "estimated_amount": 3594, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3423.56, "estimated_amount": 3423, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert/Rplacmnt Aicd W Lead Sing/Dual", "code_information": [ { "code": "33249", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 112969, "discounted_cash": 39209,"minimum": 5151,"maximum": 112969,"payers_information":[{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 90375.2, "standard_charge_percentage": 80.0000, "estimated_amount": 90375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 84726.8, "standard_charge_percentage": 75.0000, "estimated_amount": 84726, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 84726.8, "standard_charge_percentage": 75.0000, "estimated_amount": 84726, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 41798.5, "standard_charge_percentage": 37.0000, "estimated_amount": 41798, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 101672, "standard_charge_percentage": 90.0000, "estimated_amount": 101672, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 67781.4, "standard_charge_percentage": 60.0000, "estimated_amount": 67781, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 42225.3, "estimated_amount": 42225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 30764.2, "estimated_amount": 30764, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 31669, "estimated_amount": 31669, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 27331.9, "estimated_amount": 27331, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 32159.7, "estimated_amount": 32159, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 27331.9, "estimated_amount": 27331, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 84726.8, "standard_charge_percentage": 75.0000, "estimated_amount": 84726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 90375.2, "standard_charge_percentage": 80.0000, "estimated_amount": 90375, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 90375.2, "standard_charge_percentage": 80.0000, "estimated_amount": 90375, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 112969, "standard_charge_percentage": 100.0000, "estimated_amount": 112969, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 112969, "standard_charge_percentage": 100.0000, "estimated_amount": 112969, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 65522, "standard_charge_percentage": 58.0000, "estimated_amount": 65522, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 110710, "standard_charge_percentage": 98.0000, "estimated_amount": 110709, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 31669, "estimated_amount": 31669, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 40717.3, "estimated_amount": 40717, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 48257.5, "estimated_amount": 48257, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 42225.3, "estimated_amount": 42225, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 55797.8, "estimated_amount": 55797, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 60321.9, "estimated_amount": 60321, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 39357.9, "estimated_amount": 39357, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 27595.2, "estimated_amount": 27595, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 39631.2, "estimated_amount": 39631, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 84726.8, "standard_charge_percentage": 75.0000, "estimated_amount": 84726, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 101672, "standard_charge_percentage": 90.0000, "estimated_amount": 101672, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 101672, "standard_charge_percentage": 90.0000, "estimated_amount": 101672, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 96023.6, "standard_charge_percentage": 85.0000, "estimated_amount": 96023, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 45187.6, "standard_charge_percentage": 40.0000, "estimated_amount": 45187, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 98847.9, "standard_charge_percentage": 87.5000, "estimated_amount": 98847, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 90375.2, "standard_charge_percentage": 80.0000, "estimated_amount": 90375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 90375.2, "standard_charge_percentage": 80.0000, "estimated_amount": 90375, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 90375.2, "standard_charge_percentage": 80.0000, "estimated_amount": 90375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 33890.7, "standard_charge_percentage": 30.0000, "estimated_amount": 33890, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 79078.3, "standard_charge_percentage": 70.0000, "estimated_amount": 79078, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 92634.6, "standard_charge_percentage": 82.0000, "estimated_amount": 92634, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 63262.6, "standard_charge_percentage": 56.0000, "estimated_amount": 63262, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 84726.8, "standard_charge_percentage": 75.0000, "estimated_amount": 84726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 39084.6, "estimated_amount": 39084, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5151, "estimated_amount": 5151, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 90375.2, "standard_charge_percentage": 80.0000, "estimated_amount": 90375, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 56484.5, "standard_charge_percentage": 50.0000, "estimated_amount": 56484, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 101672, "standard_charge_percentage": 90.0000, "estimated_amount": 101672, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 98847.9, "standard_charge_percentage": 87.5000, "estimated_amount": 98847, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 90375.2, "standard_charge_percentage": 80.0000, "estimated_amount": 90375, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 107321, "standard_charge_percentage": 95.0000, "estimated_amount": 107320, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 67781.4, "standard_charge_percentage": 60.0000, "estimated_amount": 67781, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 90375.2, "standard_charge_percentage": 80.0000, "estimated_amount": 90375, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 79078.3, "standard_charge_percentage": 70.0000, "estimated_amount": 79078, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 79078.3, "standard_charge_percentage": 70.0000, "estimated_amount": 79078, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 90375.2, "standard_charge_percentage": 80.0000, "estimated_amount": 90375, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 101672, "standard_charge_percentage": 90.0000, "estimated_amount": 101672, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 106796, "estimated_amount": 106795, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 48257.5, "estimated_amount": 48257, "methodology": "fee schedule" }]}]} , { "description": "Hc Rem Pac Cvdfb Plse Gen &Repl Plse Gen Sngl Lead", "code_information": [ { "code": "33262", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 80256.9, "discounted_cash": 27450,"minimum": 3130,"maximum": 80256.9,"payers_information":[{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 40128.4, "standard_charge_percentage": 50.0000, "estimated_amount": 40128, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 32102.8, "standard_charge_percentage": 40.0000, "estimated_amount": 32102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 70224.8, "standard_charge_percentage": 87.5000, "estimated_amount": 70224, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 80256.9, "standard_charge_percentage": 100.0000, "estimated_amount": 80256, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 60192.7, "standard_charge_percentage": 75.0000, "estimated_amount": 60192, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 56179.8, "standard_charge_percentage": 70.0000, "estimated_amount": 56179, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 56179.8, "standard_charge_percentage": 70.0000, "estimated_amount": 56179, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 65810.7, "standard_charge_percentage": 82.0000, "estimated_amount": 65810, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 44943.9, "standard_charge_percentage": 56.0000, "estimated_amount": 44943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 29695, "standard_charge_percentage": 37.0000, "estimated_amount": 29695, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 72231.2, "standard_charge_percentage": 90.0000, "estimated_amount": 72231, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 78651.8, "standard_charge_percentage": 98.0000, "estimated_amount": 78651, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 74767.4, "estimated_amount": 74767, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 21537.9, "estimated_amount": 21537, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 28506, "estimated_amount": 28506, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 33784.9, "estimated_amount": 33784, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 29561.8, "estimated_amount": 29561, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 27554.3, "estimated_amount": 27554, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 16405.4, "estimated_amount": 16405, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 19135, "estimated_amount": 19134, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 27745.7, "estimated_amount": 27745, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 72231.2, "standard_charge_percentage": 90.0000, "estimated_amount": 72231, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 72231.2, "standard_charge_percentage": 90.0000, "estimated_amount": 72231, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 68218.4, "standard_charge_percentage": 85.0000, "estimated_amount": 68218, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 80256.9, "standard_charge_percentage": 100.0000, "estimated_amount": 80256, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 56179.8, "standard_charge_percentage": 70.0000, "estimated_amount": 56179, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 46549, "standard_charge_percentage": 58.0000, "estimated_amount": 46549, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 39063.8, "estimated_amount": 39063, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 33784.9, "estimated_amount": 33784, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 22877.6, "estimated_amount": 22877, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 27363, "estimated_amount": 27362, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 60192.7, "standard_charge_percentage": 75.0000, "estimated_amount": 60192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 70224.8, "standard_charge_percentage": 87.5000, "estimated_amount": 70224, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 48154.1, "standard_charge_percentage": 60.0000, "estimated_amount": 48154, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 24077.1, "standard_charge_percentage": 30.0000, "estimated_amount": 24077, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 60192.7, "standard_charge_percentage": 75.0000, "estimated_amount": 60192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 29561.8, "estimated_amount": 29561, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 19135, "estimated_amount": 19134, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 60192.7, "standard_charge_percentage": 75.0000, "estimated_amount": 60192, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 72231.2, "standard_charge_percentage": 90.0000, "estimated_amount": 72231, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 76244.1, "standard_charge_percentage": 95.0000, "estimated_amount": 76244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 60192.7, "standard_charge_percentage": 75.0000, "estimated_amount": 60192, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 72231.2, "standard_charge_percentage": 90.0000, "estimated_amount": 72231, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 48154.1, "standard_charge_percentage": 60.0000, "estimated_amount": 48154, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 22171.3, "estimated_amount": 22171, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 22171.3, "estimated_amount": 22171, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 42231.1, "estimated_amount": 42231, "methodology": "fee schedule" }]}]} , { "description": "Hc Rem Pac Cvdfb Plse Gen &Repl Plse Gen Dual Lead", "code_information": [ { "code": "33263", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 80256.9, "discounted_cash": 27450,"minimum": 3130,"maximum": 80256.9,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 22877.6, "estimated_amount": 22877, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 27745.7, "estimated_amount": 27745, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 27363, "estimated_amount": 27362, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 72231.2, "standard_charge_percentage": 90.0000, "estimated_amount": 72231, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 72231.2, "standard_charge_percentage": 90.0000, "estimated_amount": 72231, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 72231.2, "standard_charge_percentage": 90.0000, "estimated_amount": 72231, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 70224.8, "standard_charge_percentage": 87.5000, "estimated_amount": 70224, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 76244.1, "standard_charge_percentage": 95.0000, "estimated_amount": 76244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 46549, "standard_charge_percentage": 58.0000, "estimated_amount": 46549, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 72231.2, "standard_charge_percentage": 90.0000, "estimated_amount": 72231, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 22171.3, "estimated_amount": 22171, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 22171.3, "estimated_amount": 22171, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 39063.8, "estimated_amount": 39063, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 33784.9, "estimated_amount": 33784, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 60192.7, "standard_charge_percentage": 75.0000, "estimated_amount": 60192, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 60192.7, "standard_charge_percentage": 75.0000, "estimated_amount": 60192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 70224.8, "standard_charge_percentage": 87.5000, "estimated_amount": 70224, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 44943.9, "standard_charge_percentage": 56.0000, "estimated_amount": 44943, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 48154.1, "standard_charge_percentage": 60.0000, "estimated_amount": 48154, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 74767.4, "estimated_amount": 74767, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 28506, "estimated_amount": 28506, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 29561.8, "estimated_amount": 29561, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 19135, "estimated_amount": 19134, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 16405.4, "estimated_amount": 16405, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 19135, "estimated_amount": 19134, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 40128.4, "standard_charge_percentage": 50.0000, "estimated_amount": 40128, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 80256.9, "standard_charge_percentage": 100.0000, "estimated_amount": 80256, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 80256.9, "standard_charge_percentage": 100.0000, "estimated_amount": 80256, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 60192.7, "standard_charge_percentage": 75.0000, "estimated_amount": 60192, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 65810.7, "standard_charge_percentage": 82.0000, "estimated_amount": 65810, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 72231.2, "standard_charge_percentage": 90.0000, "estimated_amount": 72231, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 33784.9, "estimated_amount": 33784, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 42231.1, "estimated_amount": 42231, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 27554.3, "estimated_amount": 27554, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 68218.4, "standard_charge_percentage": 85.0000, "estimated_amount": 68218, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 32102.8, "standard_charge_percentage": 40.0000, "estimated_amount": 32102, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 48154.1, "standard_charge_percentage": 60.0000, "estimated_amount": 48154, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 64205.5, "standard_charge_percentage": 80.0000, "estimated_amount": 64205, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 24077.1, "standard_charge_percentage": 30.0000, "estimated_amount": 24077, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 60192.7, "standard_charge_percentage": 75.0000, "estimated_amount": 60192, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 56179.8, "standard_charge_percentage": 70.0000, "estimated_amount": 56179, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 56179.8, "standard_charge_percentage": 70.0000, "estimated_amount": 56179, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 56179.8, "standard_charge_percentage": 70.0000, "estimated_amount": 56179, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 29695, "standard_charge_percentage": 37.0000, "estimated_amount": 29695, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 78651.8, "standard_charge_percentage": 98.0000, "estimated_amount": 78651, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 60192.7, "standard_charge_percentage": 75.0000, "estimated_amount": 60192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 29561.8, "estimated_amount": 29561, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 21537.9, "estimated_amount": 21537, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 21115.6, "estimated_amount": 21115, "methodology": "fee schedule" }]}]} , { "description": "Hc Rem Pac Cvdfb Pls Gen &Repl Plse Gen Multi Lead", "code_information": [ { "code": "33264", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 170149, "discounted_cash": 39209,"minimum": 3130,"maximum": 170149,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 39357.9, "estimated_amount": 39357, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 27331.9, "estimated_amount": 27331, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 27331.9, "estimated_amount": 27331, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 39084.6, "estimated_amount": 39084, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 68059.6, "standard_charge_percentage": 40.0000, "estimated_amount": 68059, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 170149, "standard_charge_percentage": 100.0000, "estimated_amount": 170149, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 51044.7, "standard_charge_percentage": 30.0000, "estimated_amount": 51044, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 119104, "standard_charge_percentage": 70.0000, "estimated_amount": 119104, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 119104, "standard_charge_percentage": 70.0000, "estimated_amount": 119104, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 95283.4, "standard_charge_percentage": 56.0000, "estimated_amount": 95283, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 153134, "standard_charge_percentage": 90.0000, "estimated_amount": 153134, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 102089, "standard_charge_percentage": 60.0000, "estimated_amount": 102089, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 31669, "estimated_amount": 31669, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 40717.3, "estimated_amount": 40717, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 42225.3, "estimated_amount": 42225, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 55797.8, "estimated_amount": 55797, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 127612, "standard_charge_percentage": 75.0000, "estimated_amount": 127611, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 153134, "standard_charge_percentage": 90.0000, "estimated_amount": 153134, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 148880, "standard_charge_percentage": 87.5000, "estimated_amount": 148880, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 136119, "standard_charge_percentage": 80.0000, "estimated_amount": 136119, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 136119, "standard_charge_percentage": 80.0000, "estimated_amount": 136119, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 136119, "standard_charge_percentage": 80.0000, "estimated_amount": 136119, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 62955.1, "standard_charge_percentage": 37.0000, "estimated_amount": 62955, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 153134, "standard_charge_percentage": 90.0000, "estimated_amount": 153134, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 166746, "standard_charge_percentage": 98.0000, "estimated_amount": 166746, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 42225.3, "estimated_amount": 42225, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 30764.2, "estimated_amount": 30764, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 31669, "estimated_amount": 31669, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 16405.4, "estimated_amount": 16405, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 39631.2, "estimated_amount": 39631, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 136119, "standard_charge_percentage": 80.0000, "estimated_amount": 136119, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 127612, "standard_charge_percentage": 75.0000, "estimated_amount": 127611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 136119, "standard_charge_percentage": 80.0000, "estimated_amount": 136119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 85074.5, "standard_charge_percentage": 50.0000, "estimated_amount": 85074, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 153134, "standard_charge_percentage": 90.0000, "estimated_amount": 153134, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 144627, "standard_charge_percentage": 85.0000, "estimated_amount": 144626, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 136119, "standard_charge_percentage": 80.0000, "estimated_amount": 136119, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 102089, "standard_charge_percentage": 60.0000, "estimated_amount": 102089, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 136119, "standard_charge_percentage": 80.0000, "estimated_amount": 136119, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 136119, "standard_charge_percentage": 80.0000, "estimated_amount": 136119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 127612, "standard_charge_percentage": 75.0000, "estimated_amount": 127611, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 119104, "standard_charge_percentage": 70.0000, "estimated_amount": 119104, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 127612, "standard_charge_percentage": 75.0000, "estimated_amount": 127611, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 139522, "standard_charge_percentage": 82.0000, "estimated_amount": 139522, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 98686.4, "standard_charge_percentage": 58.0000, "estimated_amount": 98686, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 127612, "standard_charge_percentage": 75.0000, "estimated_amount": 127611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 48257.5, "estimated_amount": 48257, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 32159.7, "estimated_amount": 32159, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 153134, "standard_charge_percentage": 90.0000, "estimated_amount": 153134, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 148880, "standard_charge_percentage": 87.5000, "estimated_amount": 148880, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 170149, "standard_charge_percentage": 100.0000, "estimated_amount": 170149, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 161642, "standard_charge_percentage": 95.0000, "estimated_amount": 161641, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 136119, "standard_charge_percentage": 80.0000, "estimated_amount": 136119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 136119, "standard_charge_percentage": 80.0000, "estimated_amount": 136119, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 106796, "estimated_amount": 106795, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 30161, "estimated_amount": 30160, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 48257.5, "estimated_amount": 48257, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 60321.9, "estimated_amount": 60321, "methodology": "fee schedule" }]}]} , { "description": "Hc Insj Of Subq Implantable Defibrillator Electrode", "code_information": [ { "code": "33271", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 45525, "discounted_cash": 10120,"minimum": 3130,"maximum": 45525,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 10159.4, "estimated_amount": 10159, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4422.92, "estimated_amount": 4422, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 39834.4, "standard_charge_percentage": 87.5000, "estimated_amount": 39834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 39834.4, "standard_charge_percentage": 87.5000, "estimated_amount": 39834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 31867.5, "standard_charge_percentage": 70.0000, "estimated_amount": 31867, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 25494, "standard_charge_percentage": 56.0000, "estimated_amount": 25494, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 7941.08, "estimated_amount": 7941, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 15570.7, "estimated_amount": 15570, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 4422.92, "estimated_amount": 4422, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 10229.9, "estimated_amount": 10229, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 18210, "standard_charge_percentage": 40.0000, "estimated_amount": 18210, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 45525, "standard_charge_percentage": 100.0000, "estimated_amount": 45525, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 45525, "standard_charge_percentage": 100.0000, "estimated_amount": 45525, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 13657.5, "standard_charge_percentage": 30.0000, "estimated_amount": 13657, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 37330.5, "standard_charge_percentage": 82.0000, "estimated_amount": 37330, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 8183.99, "estimated_amount": 8183, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 10088.8, "estimated_amount": 10088, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 26404.5, "standard_charge_percentage": 58.0000, "estimated_amount": 26404, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 16844.3, "standard_charge_percentage": 37.0000, "estimated_amount": 16844, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 44614.5, "standard_charge_percentage": 98.0000, "estimated_amount": 44614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 27315, "standard_charge_percentage": 60.0000, "estimated_amount": 27315, "methodology": "percent of total billed charges" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 22762.5, "standard_charge_percentage": 50.0000, "estimated_amount": 22762, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 38696.3, "standard_charge_percentage": 85.0000, "estimated_amount": 38696, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 43248.8, "standard_charge_percentage": 95.0000, "estimated_amount": 43248, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 27315, "standard_charge_percentage": 60.0000, "estimated_amount": 27315, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 31867.5, "standard_charge_percentage": 70.0000, "estimated_amount": 31867, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 31867.5, "standard_charge_percentage": 70.0000, "estimated_amount": 31867, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 36420, "standard_charge_percentage": 80.0000, "estimated_amount": 36420, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 40972.5, "standard_charge_percentage": 90.0000, "estimated_amount": 40972, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 34143.8, "standard_charge_percentage": 75.0000, "estimated_amount": 34143, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 27567, "estimated_amount": 27566, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 10510.3, "estimated_amount": 10510, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 14402.9, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" }]}]} , { "description": "Hc Insertion Subq Cardiac Rhythm Monitor W/Prgrmg", "code_information": [ { "code": "33285", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 36019.2, "discounted_cash": 10120,"minimum": 1662,"maximum": 36019.2,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 27014.4, "standard_charge_percentage": 75.0000, "estimated_amount": 27014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 28815.4, "standard_charge_percentage": 80.0000, "estimated_amount": 28815, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 32417.3, "standard_charge_percentage": 90.0000, "estimated_amount": 32417, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 36019.2, "standard_charge_percentage": 100.0000, "estimated_amount": 36019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 27014.4, "standard_charge_percentage": 75.0000, "estimated_amount": 27014, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 27014.4, "standard_charge_percentage": 75.0000, "estimated_amount": 27014, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 29535.7, "standard_charge_percentage": 82.0000, "estimated_amount": 29535, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 20170.8, "standard_charge_percentage": 56.0000, "estimated_amount": 20170, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 14402.9, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 4812.67, "estimated_amount": 4812, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 8183.99, "estimated_amount": 8183, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4812.67, "estimated_amount": 4812, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 10229.9, "estimated_amount": 10229, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 10088.8, "estimated_amount": 10088, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 28815.4, "standard_charge_percentage": 80.0000, "estimated_amount": 28815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 18009.6, "standard_charge_percentage": 50.0000, "estimated_amount": 18009, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 30616.3, "standard_charge_percentage": 85.0000, "estimated_amount": 30616, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 31516.8, "standard_charge_percentage": 87.5000, "estimated_amount": 31516, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 28815.4, "standard_charge_percentage": 80.0000, "estimated_amount": 28815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 28815.4, "standard_charge_percentage": 80.0000, "estimated_amount": 28815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 28815.4, "standard_charge_percentage": 80.0000, "estimated_amount": 28815, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 36019.2, "standard_charge_percentage": 100.0000, "estimated_amount": 36019, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 34218.2, "standard_charge_percentage": 95.0000, "estimated_amount": 34218, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 28815.4, "standard_charge_percentage": 80.0000, "estimated_amount": 28815, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 25213.4, "standard_charge_percentage": 70.0000, "estimated_amount": 25213, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 20891.1, "standard_charge_percentage": 58.0000, "estimated_amount": 20891, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 32417.3, "standard_charge_percentage": 90.0000, "estimated_amount": 32417, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 32417.3, "standard_charge_percentage": 90.0000, "estimated_amount": 32417, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 35298.8, "standard_charge_percentage": 98.0000, "estimated_amount": 35298, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 10159.4, "estimated_amount": 10159, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 27014.4, "standard_charge_percentage": 75.0000, "estimated_amount": 27014, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 32417.3, "standard_charge_percentage": 90.0000, "estimated_amount": 32417, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 32417.3, "standard_charge_percentage": 90.0000, "estimated_amount": 32417, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 21611.5, "standard_charge_percentage": 60.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 28815.4, "standard_charge_percentage": 80.0000, "estimated_amount": 28815, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 28815.4, "standard_charge_percentage": 80.0000, "estimated_amount": 28815, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 13327.1, "standard_charge_percentage": 37.0000, "estimated_amount": 13327, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 28815.4, "standard_charge_percentage": 80.0000, "estimated_amount": 28815, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 27567, "estimated_amount": 27566, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 10899.5, "estimated_amount": 10899, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 15570.7, "estimated_amount": 15570, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 7055.12, "estimated_amount": 7055, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 14407.7, "standard_charge_percentage": 40.0000, "estimated_amount": 14407, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 31516.8, "standard_charge_percentage": 87.5000, "estimated_amount": 31516, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 28815.4, "standard_charge_percentage": 80.0000, "estimated_amount": 28815, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10805.8, "standard_charge_percentage": 30.0000, "estimated_amount": 10805, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 25213.4, "standard_charge_percentage": 70.0000, "estimated_amount": 25213, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 25213.4, "standard_charge_percentage": 70.0000, "estimated_amount": 25213, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 27014.4, "standard_charge_percentage": 75.0000, "estimated_amount": 27014, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 21611.5, "standard_charge_percentage": 60.0000, "estimated_amount": 21611, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 7941.08, "estimated_amount": 7941, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 10510.3, "estimated_amount": 10510, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 12456.6, "estimated_amount": 12456, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 8174.64, "estimated_amount": 8174, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 7785.37, "estimated_amount": 7785, "methodology": "fee schedule" }]}]} , { "description": "Hc Removal Subcutaneous Cardiac Rhythm Monitor", "code_information": [ { "code": "33286", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2819.08, "discounted_cash": 860,"minimum": 376.57,"maximum": 2819.08,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 650.66, "estimated_amount": 650, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 376.57, "estimated_amount": 376, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 599.8, "estimated_amount": 599, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2255.26, "standard_charge_percentage": 80.0000, "estimated_amount": 2255, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2466.7, "standard_charge_percentage": 87.5000, "estimated_amount": 2466, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2255.26, "standard_charge_percentage": 80.0000, "estimated_amount": 2255, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2255.26, "standard_charge_percentage": 80.0000, "estimated_amount": 2255, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2255.26, "standard_charge_percentage": 80.0000, "estimated_amount": 2255, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2311.65, "standard_charge_percentage": 82.0000, "estimated_amount": 2311, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1578.68, "standard_charge_percentage": 56.0000, "estimated_amount": 1578, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1635.07, "standard_charge_percentage": 58.0000, "estimated_amount": 1635, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1043.06, "standard_charge_percentage": 37.0000, "estimated_amount": 1043, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2762.7, "standard_charge_percentage": 98.0000, "estimated_amount": 2762, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 675.12, "estimated_amount": 675, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 694.97, "estimated_amount": 694, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 863.71, "estimated_amount": 863, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 376.57, "estimated_amount": 376, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 869.71, "estimated_amount": 869, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2537.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2537, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2396.22, "standard_charge_percentage": 85.0000, "estimated_amount": 2396, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1127.63, "standard_charge_percentage": 40.0000, "estimated_amount": 1127, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2255.26, "standard_charge_percentage": 80.0000, "estimated_amount": 2255, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2819.08, "standard_charge_percentage": 100.0000, "estimated_amount": 2819, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2819.08, "standard_charge_percentage": 100.0000, "estimated_amount": 2819, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2255.26, "standard_charge_percentage": 80.0000, "estimated_amount": 2255, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2255.26, "standard_charge_percentage": 80.0000, "estimated_amount": 2255, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 845.72, "standard_charge_percentage": 30.0000, "estimated_amount": 845, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1973.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2114.31, "standard_charge_percentage": 75.0000, "estimated_amount": 2114, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2114.31, "standard_charge_percentage": 75.0000, "estimated_amount": 2114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 893.54, "estimated_amount": 893, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1224.48, "estimated_amount": 1224, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 1059.01, "estimated_amount": 1059, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1323.76, "estimated_amount": 1323, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2114.31, "standard_charge_percentage": 75.0000, "estimated_amount": 2114, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2255.26, "standard_charge_percentage": 80.0000, "estimated_amount": 2255, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2114.31, "standard_charge_percentage": 75.0000, "estimated_amount": 2114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1409.54, "standard_charge_percentage": 50.0000, "estimated_amount": 1409, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2466.7, "standard_charge_percentage": 87.5000, "estimated_amount": 2466, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2114.31, "standard_charge_percentage": 75.0000, "estimated_amount": 2114, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2255.26, "standard_charge_percentage": 80.0000, "estimated_amount": 2255, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2537.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2537, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2537.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2537, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1691.45, "standard_charge_percentage": 60.0000, "estimated_amount": 1691, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 926.63, "estimated_amount": 926, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 857.71, "estimated_amount": 857, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2537.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2537, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2537.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2537, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2255.26, "standard_charge_percentage": 80.0000, "estimated_amount": 2255, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2678.13, "standard_charge_percentage": 95.0000, "estimated_amount": 2678, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1691.45, "standard_charge_percentage": 60.0000, "estimated_amount": 1691, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1973.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1973.36, "standard_charge_percentage": 70.0000, "estimated_amount": 1973, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2343.63, "estimated_amount": 2343, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 661.88, "estimated_amount": 661, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Intra-Aortic Balloon Asst Device", "code_information": [ { "code": "33967", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2537.97,"minimum": 557.16,"maximum": 2537.97,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1903.48, "standard_charge_percentage": 75.0000, "estimated_amount": 1903, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2284.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2284, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1015.19, "standard_charge_percentage": 40.0000, "estimated_amount": 1015, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2030.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2030, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2537.97, "standard_charge_percentage": 100.0000, "estimated_amount": 2537, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2411.07, "standard_charge_percentage": 95.0000, "estimated_amount": 2411, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1903.48, "standard_charge_percentage": 75.0000, "estimated_amount": 1903, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1421.26, "standard_charge_percentage": 56.0000, "estimated_amount": 1421, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1472.02, "standard_charge_percentage": 58.0000, "estimated_amount": 1472, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 939.05, "standard_charge_percentage": 37.0000, "estimated_amount": 939, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2284.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1522.78, "standard_charge_percentage": 60.0000, "estimated_amount": 1522, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2537.97, "estimated_amount": 2537, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2537.97, "estimated_amount": 2537, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 557.16, "estimated_amount": 557, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2284.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2284, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2220.72, "standard_charge_percentage": 87.5000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2220.72, "standard_charge_percentage": 87.5000, "estimated_amount": 2220, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2030.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2030, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2030.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2030, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 761.39, "standard_charge_percentage": 30.0000, "estimated_amount": 761, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1776.58, "standard_charge_percentage": 70.0000, "estimated_amount": 1776, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1903.48, "standard_charge_percentage": 75.0000, "estimated_amount": 1903, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2487.21, "standard_charge_percentage": 98.0000, "estimated_amount": 2487, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1903.48, "standard_charge_percentage": 75.0000, "estimated_amount": 1903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2030.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2030, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2537.97, "standard_charge_percentage": 100.0000, "estimated_amount": 2537, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1522.78, "standard_charge_percentage": 60.0000, "estimated_amount": 1522, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2030.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2030, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2030.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2030, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1776.58, "standard_charge_percentage": 70.0000, "estimated_amount": 1776, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2030.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2030, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2030.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2030, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1903.48, "standard_charge_percentage": 75.0000, "estimated_amount": 1903, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1268.98, "standard_charge_percentage": 50.0000, "estimated_amount": 1268, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2284.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2284, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2157.27, "standard_charge_percentage": 85.0000, "estimated_amount": 2157, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2030.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2030, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2030.38, "standard_charge_percentage": 80.0000, "estimated_amount": 2030, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1776.58, "standard_charge_percentage": 70.0000, "estimated_amount": 1776, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2081.14, "standard_charge_percentage": 82.0000, "estimated_amount": 2081, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2284.17, "standard_charge_percentage": 90.0000, "estimated_amount": 2284, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1268.98, "standard_charge_percentage": 50.0000, "estimated_amount": 1268, "methodology": "percent of total billed charges" }]}]} , { "description": "ENDOVENOUS RF 1ST VEIN", "code_information": [ { "code": "36000", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 424.88,"minimum": 127.46,"maximum": 424.88,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 318.66, "standard_charge_percentage": 75.0000, "estimated_amount": 318, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 339.9, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 339.9, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 382.39, "standard_charge_percentage": 90.0000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 339.9, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 382.39, "standard_charge_percentage": 90.0000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 416.38, "standard_charge_percentage": 98.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 382.39, "standard_charge_percentage": 90.0000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 361.15, "standard_charge_percentage": 85.0000, "estimated_amount": 361, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 169.95, "standard_charge_percentage": 40.0000, "estimated_amount": 169, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 371.77, "standard_charge_percentage": 87.5000, "estimated_amount": 371, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 403.64, "standard_charge_percentage": 95.0000, "estimated_amount": 403, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 254.93, "standard_charge_percentage": 60.0000, "estimated_amount": 254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 318.66, "standard_charge_percentage": 75.0000, "estimated_amount": 318, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 297.42, "standard_charge_percentage": 70.0000, "estimated_amount": 297, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 297.42, "standard_charge_percentage": 70.0000, "estimated_amount": 297, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 318.66, "standard_charge_percentage": 75.0000, "estimated_amount": 318, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 348.4, "standard_charge_percentage": 82.0000, "estimated_amount": 348, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 318.66, "standard_charge_percentage": 75.0000, "estimated_amount": 318, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 382.39, "standard_charge_percentage": 90.0000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 371.77, "standard_charge_percentage": 87.5000, "estimated_amount": 371, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 339.9, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 424.88, "standard_charge_percentage": 100.0000, "estimated_amount": 424, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 424.88, "standard_charge_percentage": 100.0000, "estimated_amount": 424, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 339.9, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 339.9, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 127.46, "standard_charge_percentage": 30.0000, "estimated_amount": 127, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 297.42, "standard_charge_percentage": 70.0000, "estimated_amount": 297, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 237.93, "standard_charge_percentage": 56.0000, "estimated_amount": 237, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 246.43, "standard_charge_percentage": 58.0000, "estimated_amount": 246, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 254.93, "standard_charge_percentage": 60.0000, "estimated_amount": 254, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 234, "estimated_amount": 234, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 212.44, "standard_charge_percentage": 50.0000, "estimated_amount": 212, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 339.9, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 339.9, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 339.9, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 157.21, "standard_charge_percentage": 37.0000, "estimated_amount": 157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 339.9, "standard_charge_percentage": 80.0000, "estimated_amount": 339, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 382.39, "standard_charge_percentage": 90.0000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 318.66, "standard_charge_percentage": 75.0000, "estimated_amount": 318, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 212.44, "standard_charge_percentage": 50.0000, "estimated_amount": 212, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Injection Rx Extremity Pseudoaneurysm", "code_information": [ { "code": "36002", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1636.14, "discounted_cash": 756,"minimum": 457.6,"maximum": 1636.14,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 758.97, "estimated_amount": 758, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 818.07, "standard_charge_percentage": 50.0000, "estimated_amount": 818, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1636.14, "standard_charge_percentage": 100.0000, "estimated_amount": 1636, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1308.91, "standard_charge_percentage": 80.0000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1308.91, "standard_charge_percentage": 80.0000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1227.11, "standard_charge_percentage": 75.0000, "estimated_amount": 1227, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 916.24, "standard_charge_percentage": 56.0000, "estimated_amount": 916, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1603.42, "standard_charge_percentage": 98.0000, "estimated_amount": 1603, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 593.23, "estimated_amount": 593, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1163.2, "estimated_amount": 1163, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 764.24, "estimated_amount": 764, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1227.11, "standard_charge_percentage": 75.0000, "estimated_amount": 1227, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1308.91, "standard_charge_percentage": 80.0000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1390.72, "standard_charge_percentage": 85.0000, "estimated_amount": 1390, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 654.46, "standard_charge_percentage": 40.0000, "estimated_amount": 654, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1308.91, "standard_charge_percentage": 80.0000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 490.84, "standard_charge_percentage": 30.0000, "estimated_amount": 490, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1145.3, "standard_charge_percentage": 70.0000, "estimated_amount": 1145, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 948.96, "standard_charge_percentage": 58.0000, "estimated_amount": 948, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 605.37, "standard_charge_percentage": 37.0000, "estimated_amount": 605, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1308.91, "standard_charge_percentage": 80.0000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1472.53, "standard_charge_percentage": 90.0000, "estimated_amount": 1472, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1075.96, "estimated_amount": 1075, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 457.6, "estimated_amount": 457, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 753.7, "estimated_amount": 753, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1472.53, "standard_charge_percentage": 90.0000, "estimated_amount": 1472, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1472.53, "standard_charge_percentage": 90.0000, "estimated_amount": 1472, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1431.62, "standard_charge_percentage": 87.5000, "estimated_amount": 1431, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1431.62, "standard_charge_percentage": 87.5000, "estimated_amount": 1431, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1308.91, "standard_charge_percentage": 80.0000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1227.11, "standard_charge_percentage": 75.0000, "estimated_amount": 1227, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1341.63, "standard_charge_percentage": 82.0000, "estimated_amount": 1341, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1227.11, "standard_charge_percentage": 75.0000, "estimated_amount": 1227, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 981.68, "standard_charge_percentage": 60.0000, "estimated_amount": 981, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 580.01, "estimated_amount": 580, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1636.14, "estimated_amount": 1636, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1227.11, "standard_charge_percentage": 75.0000, "estimated_amount": 1227, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1308.91, "standard_charge_percentage": 80.0000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1472.53, "standard_charge_percentage": 90.0000, "estimated_amount": 1472, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1308.91, "standard_charge_percentage": 80.0000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1308.91, "standard_charge_percentage": 80.0000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1554.33, "standard_charge_percentage": 95.0000, "estimated_amount": 1554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1636.14, "standard_charge_percentage": 100.0000, "estimated_amount": 1636, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 981.68, "standard_charge_percentage": 60.0000, "estimated_amount": 981, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1308.91, "standard_charge_percentage": 80.0000, "estimated_amount": 1308, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1145.3, "standard_charge_percentage": 70.0000, "estimated_amount": 1145, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1145.3, "standard_charge_percentage": 70.0000, "estimated_amount": 1145, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1472.53, "standard_charge_percentage": 90.0000, "estimated_amount": 1472, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1636.14, "estimated_amount": 1636, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 785.16, "estimated_amount": 785, "methodology": "fee schedule" }]}]} , { "description": "Hc Injection Proc,Extremity,Venography", "code_information": [ { "code": "36005", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1125.56,"minimum": 208,"maximum": 1125.56,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 208, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1125.56, "estimated_amount": 1125, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 844.17, "standard_charge_percentage": 75.0000, "estimated_amount": 844, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 956.73, "standard_charge_percentage": 85.0000, "estimated_amount": 956, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 900.45, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1069.28, "standard_charge_percentage": 95.0000, "estimated_amount": 1069, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 675.34, "standard_charge_percentage": 60.0000, "estimated_amount": 675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 900.45, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 900.45, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 787.89, "standard_charge_percentage": 70.0000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 787.89, "standard_charge_percentage": 70.0000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 844.17, "standard_charge_percentage": 75.0000, "estimated_amount": 844, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 900.45, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1013, "standard_charge_percentage": 90.0000, "estimated_amount": 1013, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 900.45, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 562.78, "standard_charge_percentage": 50.0000, "estimated_amount": 562, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 450.22, "standard_charge_percentage": 40.0000, "estimated_amount": 450, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 984.87, "standard_charge_percentage": 87.5000, "estimated_amount": 984, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 984.87, "standard_charge_percentage": 87.5000, "estimated_amount": 984, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 900.45, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1125.56, "standard_charge_percentage": 100.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 787.89, "standard_charge_percentage": 70.0000, "estimated_amount": 787, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 922.96, "standard_charge_percentage": 82.0000, "estimated_amount": 922, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 630.31, "standard_charge_percentage": 56.0000, "estimated_amount": 630, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 416.46, "standard_charge_percentage": 37.0000, "estimated_amount": 416, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1013, "standard_charge_percentage": 90.0000, "estimated_amount": 1013, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1013, "standard_charge_percentage": 90.0000, "estimated_amount": 1013, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1013, "standard_charge_percentage": 90.0000, "estimated_amount": 1013, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1125.56, "standard_charge_percentage": 100.0000, "estimated_amount": 1125, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 900.45, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 900.45, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 337.67, "standard_charge_percentage": 30.0000, "estimated_amount": 337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 844.17, "standard_charge_percentage": 75.0000, "estimated_amount": 844, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 652.82, "standard_charge_percentage": 58.0000, "estimated_amount": 652, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 844.17, "standard_charge_percentage": 75.0000, "estimated_amount": 844, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 900.45, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 844.17, "standard_charge_percentage": 75.0000, "estimated_amount": 844, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1013, "standard_charge_percentage": 90.0000, "estimated_amount": 1013, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 900.45, "standard_charge_percentage": 80.0000, "estimated_amount": 900, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1103.05, "standard_charge_percentage": 98.0000, "estimated_amount": 1103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 675.34, "standard_charge_percentage": 60.0000, "estimated_amount": 675, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Plc Cath In Vein,Svc,Ivc", "code_information": [ { "code": "36010", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1819.72,"minimum": 416,"maximum": 1819.72,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 909.86, "standard_charge_percentage": 50.0000, "estimated_amount": 909, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1637.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1637, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1592.26, "standard_charge_percentage": 87.5000, "estimated_amount": 1592, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1819.72, "standard_charge_percentage": 100.0000, "estimated_amount": 1819, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 545.92, "standard_charge_percentage": 30.0000, "estimated_amount": 545, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1364.79, "standard_charge_percentage": 75.0000, "estimated_amount": 1364, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1273.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1273, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1364.79, "standard_charge_percentage": 75.0000, "estimated_amount": 1364, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1637.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1637, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1637.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1637, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1364.79, "standard_charge_percentage": 75.0000, "estimated_amount": 1364, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1455.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1455.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1819.72, "standard_charge_percentage": 100.0000, "estimated_amount": 1819, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1455.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1273.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1273, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1492.17, "standard_charge_percentage": 82.0000, "estimated_amount": 1492, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1055.44, "standard_charge_percentage": 58.0000, "estimated_amount": 1055, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 673.3, "standard_charge_percentage": 37.0000, "estimated_amount": 673, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1455.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1364.79, "standard_charge_percentage": 75.0000, "estimated_amount": 1364, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1546.76, "standard_charge_percentage": 85.0000, "estimated_amount": 1546, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1091.83, "standard_charge_percentage": 60.0000, "estimated_amount": 1091, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1455.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1783.33, "standard_charge_percentage": 98.0000, "estimated_amount": 1783, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1364.79, "standard_charge_percentage": 75.0000, "estimated_amount": 1364, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1091.83, "standard_charge_percentage": 60.0000, "estimated_amount": 1091, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 416, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1455.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1637.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1637, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1637.75, "standard_charge_percentage": 90.0000, "estimated_amount": 1637, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 727.89, "standard_charge_percentage": 40.0000, "estimated_amount": 727, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1592.26, "standard_charge_percentage": 87.5000, "estimated_amount": 1592, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1455.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1728.73, "standard_charge_percentage": 95.0000, "estimated_amount": 1728, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1455.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1455.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1273.8, "standard_charge_percentage": 70.0000, "estimated_amount": 1273, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1019.04, "standard_charge_percentage": 56.0000, "estimated_amount": 1019, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1455.78, "standard_charge_percentage": 80.0000, "estimated_amount": 1455, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Place Cath In Vein,Select", "code_information": [ { "code": "36011", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1645.32,"minimum": 416,"maximum": 1645.32,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1645.32, "estimated_amount": 1645, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1316.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1480.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1480, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1439.65, "standard_charge_percentage": 87.5000, "estimated_amount": 1439, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1316.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1316.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1233.99, "standard_charge_percentage": 75.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1151.72, "standard_charge_percentage": 70.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 416, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1316.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 658.13, "standard_charge_percentage": 40.0000, "estimated_amount": 658, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1439.65, "standard_charge_percentage": 87.5000, "estimated_amount": 1439, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1316.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1316.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1316.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1316.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 493.6, "standard_charge_percentage": 30.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1233.99, "standard_charge_percentage": 75.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1349.16, "standard_charge_percentage": 82.0000, "estimated_amount": 1349, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 921.38, "standard_charge_percentage": 56.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1480.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1480, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1316.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1645.32, "standard_charge_percentage": 100.0000, "estimated_amount": 1645, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1151.72, "standard_charge_percentage": 70.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 954.29, "standard_charge_percentage": 58.0000, "estimated_amount": 954, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 608.77, "standard_charge_percentage": 37.0000, "estimated_amount": 608, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1316.26, "standard_charge_percentage": 80.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1480.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1480, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1612.41, "standard_charge_percentage": 98.0000, "estimated_amount": 1612, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 987.19, "standard_charge_percentage": 60.0000, "estimated_amount": 987, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1233.99, "standard_charge_percentage": 75.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1233.99, "standard_charge_percentage": 75.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 822.66, "standard_charge_percentage": 50.0000, "estimated_amount": 822, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1480.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1480, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1480.79, "standard_charge_percentage": 90.0000, "estimated_amount": 1480, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1398.52, "standard_charge_percentage": 85.0000, "estimated_amount": 1398, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1563.05, "standard_charge_percentage": 95.0000, "estimated_amount": 1563, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1645.32, "standard_charge_percentage": 100.0000, "estimated_amount": 1645, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 987.19, "standard_charge_percentage": 60.0000, "estimated_amount": 987, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1151.72, "standard_charge_percentage": 70.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1233.99, "standard_charge_percentage": 75.0000, "estimated_amount": 1233, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Place Cath In Lt/Rt Pulm Art", "code_information": [ { "code": "36014", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1507.63,"minimum": 416,"maximum": 1507.63,"payers_information":[{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1206.1, "standard_charge_percentage": 80.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 753.82, "standard_charge_percentage": 50.0000, "estimated_amount": 753, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1356.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1206.1, "standard_charge_percentage": 80.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1206.1, "standard_charge_percentage": 80.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1206.1, "standard_charge_percentage": 80.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1236.26, "standard_charge_percentage": 82.0000, "estimated_amount": 1236, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 874.43, "standard_charge_percentage": 58.0000, "estimated_amount": 874, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1356.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1206.1, "standard_charge_percentage": 80.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1130.72, "standard_charge_percentage": 75.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1356.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 603.05, "standard_charge_percentage": 40.0000, "estimated_amount": 603, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1319.18, "standard_charge_percentage": 87.5000, "estimated_amount": 1319, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1206.1, "standard_charge_percentage": 80.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1507.63, "standard_charge_percentage": 100.0000, "estimated_amount": 1507, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 904.58, "standard_charge_percentage": 60.0000, "estimated_amount": 904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1130.72, "standard_charge_percentage": 75.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1055.34, "standard_charge_percentage": 70.0000, "estimated_amount": 1055, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 844.27, "standard_charge_percentage": 56.0000, "estimated_amount": 844, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1356.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 416, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1130.72, "standard_charge_percentage": 75.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1356.87, "standard_charge_percentage": 90.0000, "estimated_amount": 1356, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1206.1, "standard_charge_percentage": 80.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1206.1, "standard_charge_percentage": 80.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1206.1, "standard_charge_percentage": 80.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 452.29, "standard_charge_percentage": 30.0000, "estimated_amount": 452, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1055.34, "standard_charge_percentage": 70.0000, "estimated_amount": 1055, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1130.72, "standard_charge_percentage": 75.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1130.72, "standard_charge_percentage": 75.0000, "estimated_amount": 1130, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1507.63, "estimated_amount": 1507, "methodology": "case rate" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1281.49, "standard_charge_percentage": 85.0000, "estimated_amount": 1281, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1319.18, "standard_charge_percentage": 87.5000, "estimated_amount": 1319, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1507.63, "standard_charge_percentage": 100.0000, "estimated_amount": 1507, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1432.25, "standard_charge_percentage": 95.0000, "estimated_amount": 1432, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1055.34, "standard_charge_percentage": 70.0000, "estimated_amount": 1055, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 557.82, "standard_charge_percentage": 37.0000, "estimated_amount": 557, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1206.1, "standard_charge_percentage": 80.0000, "estimated_amount": 1206, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1477.48, "standard_charge_percentage": 98.0000, "estimated_amount": 1477, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 904.58, "standard_charge_percentage": 60.0000, "estimated_amount": 904, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Place Cath In Artery, Slctv In Pulm Art (Segmental Or Subseg)", "code_information": [ { "code": "36015", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3290.2,"minimum": 416,"maximum": 3290.2,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2632.16, "standard_charge_percentage": 80.0000, "estimated_amount": 2632, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2961.18, "standard_charge_percentage": 90.0000, "estimated_amount": 2961, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1316.08, "standard_charge_percentage": 40.0000, "estimated_amount": 1316, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 2878.93, "standard_charge_percentage": 87.5000, "estimated_amount": 2878, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2632.16, "standard_charge_percentage": 80.0000, "estimated_amount": 2632, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2632.16, "standard_charge_percentage": 80.0000, "estimated_amount": 2632, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3125.69, "standard_charge_percentage": 95.0000, "estimated_amount": 3125, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3290.2, "standard_charge_percentage": 100.0000, "estimated_amount": 3290, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2632.16, "standard_charge_percentage": 80.0000, "estimated_amount": 2632, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2632.16, "standard_charge_percentage": 80.0000, "estimated_amount": 2632, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2303.14, "standard_charge_percentage": 70.0000, "estimated_amount": 2303, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2632.16, "standard_charge_percentage": 80.0000, "estimated_amount": 2632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 416, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3290.2, "standard_charge_percentage": 100.0000, "estimated_amount": 3290, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2632.16, "standard_charge_percentage": 80.0000, "estimated_amount": 2632, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2697.96, "standard_charge_percentage": 82.0000, "estimated_amount": 2697, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2961.18, "standard_charge_percentage": 90.0000, "estimated_amount": 2961, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2961.18, "standard_charge_percentage": 90.0000, "estimated_amount": 2961, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3224.4, "standard_charge_percentage": 98.0000, "estimated_amount": 3224, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1974.12, "standard_charge_percentage": 60.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2467.65, "standard_charge_percentage": 75.0000, "estimated_amount": 2467, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 2796.67, "standard_charge_percentage": 85.0000, "estimated_amount": 2796, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 2878.93, "standard_charge_percentage": 87.5000, "estimated_amount": 2878, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2632.16, "standard_charge_percentage": 80.0000, "estimated_amount": 2632, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1974.12, "standard_charge_percentage": 60.0000, "estimated_amount": 1974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2467.65, "standard_charge_percentage": 75.0000, "estimated_amount": 2467, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2303.14, "standard_charge_percentage": 70.0000, "estimated_amount": 2303, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2467.65, "standard_charge_percentage": 75.0000, "estimated_amount": 2467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2632.16, "standard_charge_percentage": 80.0000, "estimated_amount": 2632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1645.1, "standard_charge_percentage": 50.0000, "estimated_amount": 1645, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2961.18, "standard_charge_percentage": 90.0000, "estimated_amount": 2961, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2961.18, "standard_charge_percentage": 90.0000, "estimated_amount": 2961, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2632.16, "standard_charge_percentage": 80.0000, "estimated_amount": 2632, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 987.06, "standard_charge_percentage": 30.0000, "estimated_amount": 987, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2303.14, "standard_charge_percentage": 70.0000, "estimated_amount": 2303, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2467.65, "standard_charge_percentage": 75.0000, "estimated_amount": 2467, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1842.51, "standard_charge_percentage": 56.0000, "estimated_amount": 1842, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1908.32, "standard_charge_percentage": 58.0000, "estimated_amount": 1908, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1217.37, "standard_charge_percentage": 37.0000, "estimated_amount": 1217, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2467.65, "standard_charge_percentage": 75.0000, "estimated_amount": 2467, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Plc Cath Extrem Artery", "code_information": [ { "code": "36140", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1088.84,"minimum": 326.65,"maximum": 1088.84,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 416, "estimated_amount": 416, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 871.07, "standard_charge_percentage": 80.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 544.42, "standard_charge_percentage": 50.0000, "estimated_amount": 544, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 435.54, "standard_charge_percentage": 40.0000, "estimated_amount": 435, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 952.74, "standard_charge_percentage": 87.5000, "estimated_amount": 952, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 871.07, "standard_charge_percentage": 80.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 762.19, "standard_charge_percentage": 70.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 816.63, "standard_charge_percentage": 75.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 979.96, "standard_charge_percentage": 90.0000, "estimated_amount": 979, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 653.3, "standard_charge_percentage": 60.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1088.84, "estimated_amount": 1088, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 979.96, "standard_charge_percentage": 90.0000, "estimated_amount": 979, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 871.07, "standard_charge_percentage": 80.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 609.75, "standard_charge_percentage": 56.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 979.96, "standard_charge_percentage": 90.0000, "estimated_amount": 979, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 871.07, "standard_charge_percentage": 80.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 925.51, "standard_charge_percentage": 85.0000, "estimated_amount": 925, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 952.74, "standard_charge_percentage": 87.5000, "estimated_amount": 952, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 871.07, "standard_charge_percentage": 80.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1034.4, "standard_charge_percentage": 95.0000, "estimated_amount": 1034, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 653.3, "standard_charge_percentage": 60.0000, "estimated_amount": 653, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 871.07, "standard_charge_percentage": 80.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 871.07, "standard_charge_percentage": 80.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 816.63, "standard_charge_percentage": 75.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 631.53, "standard_charge_percentage": 58.0000, "estimated_amount": 631, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 402.87, "standard_charge_percentage": 37.0000, "estimated_amount": 402, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1067.06, "standard_charge_percentage": 98.0000, "estimated_amount": 1067, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 816.63, "standard_charge_percentage": 75.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 816.63, "standard_charge_percentage": 75.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 816.63, "standard_charge_percentage": 75.0000, "estimated_amount": 816, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 979.96, "standard_charge_percentage": 90.0000, "estimated_amount": 979, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 979.96, "standard_charge_percentage": 90.0000, "estimated_amount": 979, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 871.07, "standard_charge_percentage": 80.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1088.84, "standard_charge_percentage": 100.0000, "estimated_amount": 1088, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1088.84, "standard_charge_percentage": 100.0000, "estimated_amount": 1088, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 871.07, "standard_charge_percentage": 80.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 326.65, "standard_charge_percentage": 30.0000, "estimated_amount": 326, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 762.19, "standard_charge_percentage": 70.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 762.19, "standard_charge_percentage": 70.0000, "estimated_amount": 762, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 892.85, "standard_charge_percentage": 82.0000, "estimated_amount": 892, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 871.07, "standard_charge_percentage": 80.0000, "estimated_amount": 871, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Plc Cath Selective Art,Neck", "code_information": [ { "code": "36215", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4143.35,"minimum": 624,"maximum": 4143.35,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3107.51, "standard_charge_percentage": 75.0000, "estimated_amount": 3107, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1657.34, "standard_charge_percentage": 40.0000, "estimated_amount": 1657, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3625.43, "standard_charge_percentage": 87.5000, "estimated_amount": 3625, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3936.18, "standard_charge_percentage": 95.0000, "estimated_amount": 3936, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2900.34, "standard_charge_percentage": 70.0000, "estimated_amount": 2900, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3397.55, "standard_charge_percentage": 82.0000, "estimated_amount": 3397, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2320.28, "standard_charge_percentage": 56.0000, "estimated_amount": 2320, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1533.04, "standard_charge_percentage": 37.0000, "estimated_amount": 1533, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3314.68, "standard_charge_percentage": 80.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3729.02, "standard_charge_percentage": 90.0000, "estimated_amount": 3729, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3314.68, "standard_charge_percentage": 80.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3107.51, "standard_charge_percentage": 75.0000, "estimated_amount": 3107, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3625.43, "standard_charge_percentage": 87.5000, "estimated_amount": 3625, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 4143.35, "standard_charge_percentage": 100.0000, "estimated_amount": 4143, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2486.01, "standard_charge_percentage": 60.0000, "estimated_amount": 2486, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3107.51, "standard_charge_percentage": 75.0000, "estimated_amount": 3107, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2900.34, "standard_charge_percentage": 70.0000, "estimated_amount": 2900, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3729.02, "standard_charge_percentage": 90.0000, "estimated_amount": 3729, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 4060.48, "standard_charge_percentage": 98.0000, "estimated_amount": 4060, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3107.51, "standard_charge_percentage": 75.0000, "estimated_amount": 3107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3314.68, "standard_charge_percentage": 80.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3729.02, "standard_charge_percentage": 90.0000, "estimated_amount": 3729, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3729.02, "standard_charge_percentage": 90.0000, "estimated_amount": 3729, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3314.68, "standard_charge_percentage": 80.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3314.68, "standard_charge_percentage": 80.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3314.68, "standard_charge_percentage": 80.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3314.68, "standard_charge_percentage": 80.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1243.01, "standard_charge_percentage": 30.0000, "estimated_amount": 1243, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2403.14, "standard_charge_percentage": 58.0000, "estimated_amount": 2403, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 624, "estimated_amount": 624, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2071.68, "standard_charge_percentage": 50.0000, "estimated_amount": 2071, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3729.02, "standard_charge_percentage": 90.0000, "estimated_amount": 3729, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3521.85, "standard_charge_percentage": 85.0000, "estimated_amount": 3521, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3314.68, "standard_charge_percentage": 80.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 4143.35, "standard_charge_percentage": 100.0000, "estimated_amount": 4143, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3314.68, "standard_charge_percentage": 80.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3314.68, "standard_charge_percentage": 80.0000, "estimated_amount": 3314, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2900.34, "standard_charge_percentage": 70.0000, "estimated_amount": 2900, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3107.51, "standard_charge_percentage": 75.0000, "estimated_amount": 3107, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2486.01, "standard_charge_percentage": 60.0000, "estimated_amount": 2486, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Slctv Cath Subclavian Art Angio Vertebral Art", "code_information": [ { "code": "36225", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 15973.6, "discounted_cash": 3849,"minimum": 1500.6,"maximum": 15973.6,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 12778.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12778.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12778, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 14376.2, "standard_charge_percentage": 90.0000, "estimated_amount": 14376, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 14376.2, "standard_charge_percentage": 90.0000, "estimated_amount": 14376, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12778.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12778, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 5910.23, "standard_charge_percentage": 37.0000, "estimated_amount": 5910, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 10484.2, "estimated_amount": 10484, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 14376.2, "standard_charge_percentage": 90.0000, "estimated_amount": 14376, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 13577.6, "standard_charge_percentage": 85.0000, "estimated_amount": 13577, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6389.44, "standard_charge_percentage": 40.0000, "estimated_amount": 6389, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 12778.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 9584.16, "standard_charge_percentage": 60.0000, "estimated_amount": 9584, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 11980.2, "standard_charge_percentage": 75.0000, "estimated_amount": 11980, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 13976.9, "standard_charge_percentage": 87.5000, "estimated_amount": 13976, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 12778.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12778, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 12778.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12778, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 15973.6, "standard_charge_percentage": 100.0000, "estimated_amount": 15973, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 15973.6, "standard_charge_percentage": 100.0000, "estimated_amount": 15973, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 9584.16, "standard_charge_percentage": 60.0000, "estimated_amount": 9584, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 12778.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 11980.2, "standard_charge_percentage": 75.0000, "estimated_amount": 11980, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 11980.2, "standard_charge_percentage": 75.0000, "estimated_amount": 11980, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 13098.4, "standard_charge_percentage": 82.0000, "estimated_amount": 13098, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8945.22, "standard_charge_percentage": 56.0000, "estimated_amount": 8945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12778.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12778, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 15654.1, "standard_charge_percentage": 98.0000, "estimated_amount": 15654, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1500.6, "estimated_amount": 1500, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 11980.2, "standard_charge_percentage": 75.0000, "estimated_amount": 11980, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 7986.8, "standard_charge_percentage": 50.0000, "estimated_amount": 7986, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 13976.9, "standard_charge_percentage": 87.5000, "estimated_amount": 13976, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 12778.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12778, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 15174.9, "standard_charge_percentage": 95.0000, "estimated_amount": 15174, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 12778.9, "standard_charge_percentage": 80.0000, "estimated_amount": 12778, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4792.08, "standard_charge_percentage": 30.0000, "estimated_amount": 4792, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 11181.5, "standard_charge_percentage": 70.0000, "estimated_amount": 11181, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 11181.5, "standard_charge_percentage": 70.0000, "estimated_amount": 11181, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 11181.5, "standard_charge_percentage": 70.0000, "estimated_amount": 11181, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9264.69, "standard_charge_percentage": 58.0000, "estimated_amount": 9264, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 14376.2, "standard_charge_percentage": 90.0000, "estimated_amount": 14376, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 14376.2, "standard_charge_percentage": 90.0000, "estimated_amount": 14376, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 11980.2, "standard_charge_percentage": 75.0000, "estimated_amount": 11980, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" }]}]} , { "description": "Hc Place Cath Select Art,Abd/Pel", "code_information": [ { "code": "36245", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1794.48,"minimum": 538.34,"maximum": 1794.48,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1435.58, "standard_charge_percentage": 80.0000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1435.58, "standard_charge_percentage": 80.0000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1615.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1615, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1435.58, "standard_charge_percentage": 80.0000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1435.58, "standard_charge_percentage": 80.0000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1704.76, "standard_charge_percentage": 95.0000, "estimated_amount": 1704, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1435.58, "standard_charge_percentage": 80.0000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1435.58, "standard_charge_percentage": 80.0000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1345.86, "standard_charge_percentage": 75.0000, "estimated_amount": 1345, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1256.14, "standard_charge_percentage": 70.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1256.14, "standard_charge_percentage": 70.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1345.86, "standard_charge_percentage": 75.0000, "estimated_amount": 1345, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1615.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1615, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1345.86, "standard_charge_percentage": 75.0000, "estimated_amount": 1345, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 897.24, "standard_charge_percentage": 50.0000, "estimated_amount": 897, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1525.31, "standard_charge_percentage": 85.0000, "estimated_amount": 1525, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 717.79, "standard_charge_percentage": 40.0000, "estimated_amount": 717, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1570.17, "standard_charge_percentage": 87.5000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1471.47, "standard_charge_percentage": 82.0000, "estimated_amount": 1471, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 663.96, "standard_charge_percentage": 37.0000, "estimated_amount": 663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1435.58, "standard_charge_percentage": 80.0000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 624, "estimated_amount": 624, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1615.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1615, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1794.48, "standard_charge_percentage": 100.0000, "estimated_amount": 1794, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1076.69, "standard_charge_percentage": 60.0000, "estimated_amount": 1076, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1435.58, "standard_charge_percentage": 80.0000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 538.34, "standard_charge_percentage": 30.0000, "estimated_amount": 538, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1004.91, "standard_charge_percentage": 56.0000, "estimated_amount": 1004, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1040.8, "standard_charge_percentage": 58.0000, "estimated_amount": 1040, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1076.69, "standard_charge_percentage": 60.0000, "estimated_amount": 1076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1794.48, "estimated_amount": 1794, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1345.86, "standard_charge_percentage": 75.0000, "estimated_amount": 1345, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1615.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1615, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1570.17, "standard_charge_percentage": 87.5000, "estimated_amount": 1570, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1435.58, "standard_charge_percentage": 80.0000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1794.48, "standard_charge_percentage": 100.0000, "estimated_amount": 1794, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1435.58, "standard_charge_percentage": 80.0000, "estimated_amount": 1435, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1256.14, "standard_charge_percentage": 70.0000, "estimated_amount": 1256, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1615.03, "standard_charge_percentage": 90.0000, "estimated_amount": 1615, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1758.59, "standard_charge_percentage": 98.0000, "estimated_amount": 1758, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1345.86, "standard_charge_percentage": 75.0000, "estimated_amount": 1345, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Place Cath Subselect Art,Abd/Pel", "code_information": [ { "code": "36246", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1893.15,"minimum": 567.95,"maximum": 1893.15,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1419.86, "standard_charge_percentage": 75.0000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1514.52, "standard_charge_percentage": 80.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1703.84, "standard_charge_percentage": 90.0000, "estimated_amount": 1703, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1609.18, "standard_charge_percentage": 85.0000, "estimated_amount": 1609, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1893.15, "standard_charge_percentage": 100.0000, "estimated_amount": 1893, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1325.2, "standard_charge_percentage": 70.0000, "estimated_amount": 1325, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1325.2, "standard_charge_percentage": 70.0000, "estimated_amount": 1325, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1098.03, "standard_charge_percentage": 58.0000, "estimated_amount": 1098, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 624, "estimated_amount": 624, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1893.15, "estimated_amount": 1893, "methodology": "case rate" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1798.49, "standard_charge_percentage": 95.0000, "estimated_amount": 1798, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1135.89, "standard_charge_percentage": 60.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1514.52, "standard_charge_percentage": 80.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 567.95, "standard_charge_percentage": 30.0000, "estimated_amount": 567, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1325.2, "standard_charge_percentage": 70.0000, "estimated_amount": 1325, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1552.38, "standard_charge_percentage": 82.0000, "estimated_amount": 1552, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1703.84, "standard_charge_percentage": 90.0000, "estimated_amount": 1703, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1514.52, "standard_charge_percentage": 80.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 946.58, "standard_charge_percentage": 50.0000, "estimated_amount": 946, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1703.84, "standard_charge_percentage": 90.0000, "estimated_amount": 1703, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1514.52, "standard_charge_percentage": 80.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1514.52, "standard_charge_percentage": 80.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1514.52, "standard_charge_percentage": 80.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1419.86, "standard_charge_percentage": 75.0000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1060.16, "standard_charge_percentage": 56.0000, "estimated_amount": 1060, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 700.47, "standard_charge_percentage": 37.0000, "estimated_amount": 700, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1703.84, "standard_charge_percentage": 90.0000, "estimated_amount": 1703, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1419.86, "standard_charge_percentage": 75.0000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1135.89, "standard_charge_percentage": 60.0000, "estimated_amount": 1135, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1419.86, "standard_charge_percentage": 75.0000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1703.84, "standard_charge_percentage": 90.0000, "estimated_amount": 1703, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 757.26, "standard_charge_percentage": 40.0000, "estimated_amount": 757, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1656.51, "standard_charge_percentage": 87.5000, "estimated_amount": 1656, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1656.51, "standard_charge_percentage": 87.5000, "estimated_amount": 1656, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1514.52, "standard_charge_percentage": 80.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1514.52, "standard_charge_percentage": 80.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1893.15, "standard_charge_percentage": 100.0000, "estimated_amount": 1893, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1514.52, "standard_charge_percentage": 80.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1419.86, "standard_charge_percentage": 75.0000, "estimated_amount": 1419, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1514.52, "standard_charge_percentage": 80.0000, "estimated_amount": 1514, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1855.29, "standard_charge_percentage": 98.0000, "estimated_amount": 1855, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Place Cath Subsubselect Art,Abd/Pel", "code_information": [ { "code": "36247", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 4847.61,"minimum": 624,"maximum": 4847.61,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 4362.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1939.04, "standard_charge_percentage": 40.0000, "estimated_amount": 1939, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3878.09, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3635.71, "standard_charge_percentage": 75.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3393.33, "standard_charge_percentage": 70.0000, "estimated_amount": 3393, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3635.71, "standard_charge_percentage": 75.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1793.62, "standard_charge_percentage": 37.0000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 4750.66, "standard_charge_percentage": 98.0000, "estimated_amount": 4750, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3878.09, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 4362.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3878.09, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2811.61, "standard_charge_percentage": 58.0000, "estimated_amount": 2811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3878.09, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3635.71, "standard_charge_percentage": 75.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 624, "estimated_amount": 624, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3635.71, "standard_charge_percentage": 75.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3635.71, "standard_charge_percentage": 75.0000, "estimated_amount": 3635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3878.09, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 4362.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 4241.66, "standard_charge_percentage": 87.5000, "estimated_amount": 4241, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3878.09, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3878.09, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2908.57, "standard_charge_percentage": 60.0000, "estimated_amount": 2908, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3878.09, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3878.09, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1454.28, "standard_charge_percentage": 30.0000, "estimated_amount": 1454, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3393.33, "standard_charge_percentage": 70.0000, "estimated_amount": 3393, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3975.04, "standard_charge_percentage": 82.0000, "estimated_amount": 3975, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 4362.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 4362.85, "standard_charge_percentage": 90.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2423.8, "standard_charge_percentage": 50.0000, "estimated_amount": 2423, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4120.47, "standard_charge_percentage": 85.0000, "estimated_amount": 4120, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 4241.66, "standard_charge_percentage": 87.5000, "estimated_amount": 4241, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 4847.61, "standard_charge_percentage": 100.0000, "estimated_amount": 4847, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 4605.23, "standard_charge_percentage": 95.0000, "estimated_amount": 4605, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 4847.61, "standard_charge_percentage": 100.0000, "estimated_amount": 4847, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3878.09, "standard_charge_percentage": 80.0000, "estimated_amount": 3878, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3393.33, "standard_charge_percentage": 70.0000, "estimated_amount": 3393, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2714.66, "standard_charge_percentage": 56.0000, "estimated_amount": 2714, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2908.57, "standard_charge_percentage": 60.0000, "estimated_amount": 2908, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Place Cath Addn Subsel Art,Abd/Pel", "code_information": [ { "code": "36248", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3990.53,"minimum": 624,"maximum": 3990.53,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3491.71, "standard_charge_percentage": 87.5000, "estimated_amount": 3491, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3990.53, "standard_charge_percentage": 100.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1197.16, "standard_charge_percentage": 30.0000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2234.7, "standard_charge_percentage": 56.0000, "estimated_amount": 2234, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2394.32, "standard_charge_percentage": 60.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 624, "estimated_amount": 624, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3491.71, "standard_charge_percentage": 87.5000, "estimated_amount": 3491, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2394.32, "standard_charge_percentage": 60.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1476.5, "standard_charge_percentage": 37.0000, "estimated_amount": 1476, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3990.53, "standard_charge_percentage": 100.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2314.51, "standard_charge_percentage": 58.0000, "estimated_amount": 2314, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3910.72, "standard_charge_percentage": 98.0000, "estimated_amount": 3910, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1995.27, "standard_charge_percentage": 50.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3391.95, "standard_charge_percentage": 85.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1596.21, "standard_charge_percentage": 40.0000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3791, "standard_charge_percentage": 95.0000, "estimated_amount": 3791, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3272.23, "standard_charge_percentage": 82.0000, "estimated_amount": 3272, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Slctv Cath 1Stord W/Wo Art Punct/Fluoro/S&I Uni", "code_information": [ { "code": "36251", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9639, "discounted_cash": 3849,"minimum": 1410.56,"maximum": 9639,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4819.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4819, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8434.13, "standard_charge_percentage": 87.5000, "estimated_amount": 8434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8434.13, "standard_charge_percentage": 87.5000, "estimated_amount": 8434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 9157.05, "standard_charge_percentage": 95.0000, "estimated_amount": 9157, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2891.7, "standard_charge_percentage": 30.0000, "estimated_amount": 2891, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7903.98, "standard_charge_percentage": 82.0000, "estimated_amount": 7903, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5397.84, "standard_charge_percentage": 56.0000, "estimated_amount": 5397, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5590.62, "standard_charge_percentage": 58.0000, "estimated_amount": 5590, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3566.43, "standard_charge_percentage": 37.0000, "estimated_amount": 3566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 8193.15, "standard_charge_percentage": 85.0000, "estimated_amount": 8193, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3855.6, "standard_charge_percentage": 40.0000, "estimated_amount": 3855, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9639, "standard_charge_percentage": 100.0000, "estimated_amount": 9639, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9446.22, "standard_charge_percentage": 98.0000, "estimated_amount": 9446, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9639, "estimated_amount": 9639, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9639, "standard_charge_percentage": 100.0000, "estimated_amount": 9639, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5783.4, "standard_charge_percentage": 60.0000, "estimated_amount": 5783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1410.56, "estimated_amount": 1410, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5783.4, "standard_charge_percentage": 60.0000, "estimated_amount": 5783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" }]}]} , { "description": "Hc Slctv Cath 1Stord W/Wo Art Punct/Fluor/S&I Bila", "code_information": [ { "code": "36252", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9095.15, "discounted_cash": 3849,"minimum": 2488,"maximum": 9095.15,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7958.26, "standard_charge_percentage": 87.5000, "estimated_amount": 7958, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9095.15, "standard_charge_percentage": 100.0000, "estimated_amount": 9095, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3365.21, "standard_charge_percentage": 37.0000, "estimated_amount": 3365, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4547.57, "standard_charge_percentage": 50.0000, "estimated_amount": 4547, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7730.88, "standard_charge_percentage": 85.0000, "estimated_amount": 7730, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2728.55, "standard_charge_percentage": 30.0000, "estimated_amount": 2728, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7458.02, "standard_charge_percentage": 82.0000, "estimated_amount": 7458, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5275.19, "standard_charge_percentage": 58.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5457.09, "standard_charge_percentage": 60.0000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9095.15, "estimated_amount": 9095, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9095.15, "standard_charge_percentage": 100.0000, "estimated_amount": 9095, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5093.28, "standard_charge_percentage": 56.0000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3638.06, "standard_charge_percentage": 40.0000, "estimated_amount": 3638, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7958.26, "standard_charge_percentage": 87.5000, "estimated_amount": 7958, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8640.39, "standard_charge_percentage": 95.0000, "estimated_amount": 8640, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5457.09, "standard_charge_percentage": 60.0000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8913.25, "standard_charge_percentage": 98.0000, "estimated_amount": 8913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" }]}]} , { "description": "Hc Vnpnxr 3 Years/> Phys/Qhp Skill", "code_information": [ { "code": "36410", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1535.58,"minimum": 13.52,"maximum": 1535.58,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 13.52, "estimated_amount": 13, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 614.23, "standard_charge_percentage": 40.0000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1535.58, "standard_charge_percentage": 100.0000, "estimated_amount": 1535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1535.58, "standard_charge_percentage": 100.0000, "estimated_amount": 1535, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1228.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 460.67, "standard_charge_percentage": 30.0000, "estimated_amount": 460, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1151.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 890.64, "standard_charge_percentage": 58.0000, "estimated_amount": 890, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 568.16, "standard_charge_percentage": 37.0000, "estimated_amount": 568, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1228.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1504.87, "standard_charge_percentage": 98.0000, "estimated_amount": 1504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 921.35, "standard_charge_percentage": 60.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 767.79, "standard_charge_percentage": 50.0000, "estimated_amount": 767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1228.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1382.02, "standard_charge_percentage": 90.0000, "estimated_amount": 1382, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1343.63, "standard_charge_percentage": 87.5000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1228.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 921.35, "standard_charge_percentage": 60.0000, "estimated_amount": 921, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1074.91, "standard_charge_percentage": 70.0000, "estimated_amount": 1074, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1151.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1382.02, "standard_charge_percentage": 90.0000, "estimated_amount": 1382, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1382.02, "standard_charge_percentage": 90.0000, "estimated_amount": 1382, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1382.02, "standard_charge_percentage": 90.0000, "estimated_amount": 1382, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1305.24, "standard_charge_percentage": 85.0000, "estimated_amount": 1305, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1228.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1458.8, "standard_charge_percentage": 95.0000, "estimated_amount": 1458, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1228.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1228.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1074.91, "standard_charge_percentage": 70.0000, "estimated_amount": 1074, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1074.91, "standard_charge_percentage": 70.0000, "estimated_amount": 1074, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1259.18, "standard_charge_percentage": 82.0000, "estimated_amount": 1259, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1382.02, "standard_charge_percentage": 90.0000, "estimated_amount": 1382, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1151.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1228.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1151.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 767.79, "standard_charge_percentage": 50.0000, "estimated_amount": 767, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1343.63, "standard_charge_percentage": 87.5000, "estimated_amount": 1343, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1228.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1228.46, "standard_charge_percentage": 80.0000, "estimated_amount": 1228, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 859.92, "standard_charge_percentage": 56.0000, "estimated_amount": 859, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1151.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1151, "methodology": "percent of total billed charges" }]}]} , { "description": "VENIPUNCTURE", "code_information": [ { "code": "36415", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 53.92, "discounted_cash": 11,"minimum": 8.18,"maximum": 53.92,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 43.14, "standard_charge_percentage": 80.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 26.96, "standard_charge_percentage": 50.0000, "estimated_amount": 26, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 47.18, "standard_charge_percentage": 87.5000, "estimated_amount": 47, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 51.22, "standard_charge_percentage": 95.0000, "estimated_amount": 51, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 32.35, "standard_charge_percentage": 60.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 40.44, "standard_charge_percentage": 75.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 37.74, "standard_charge_percentage": 70.0000, "estimated_amount": 37, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 52.84, "standard_charge_percentage": 98.0000, "estimated_amount": 52, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 9.27, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 14.54, "estimated_amount": 14, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 43.14, "standard_charge_percentage": 80.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 48.53, "standard_charge_percentage": 90.0000, "estimated_amount": 48, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 45.83, "standard_charge_percentage": 85.0000, "estimated_amount": 45, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 43.14, "standard_charge_percentage": 80.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 43.14, "standard_charge_percentage": 80.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 43.14, "standard_charge_percentage": 80.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 43.14, "standard_charge_percentage": 80.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 40.44, "standard_charge_percentage": 75.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 48.53, "standard_charge_percentage": 90.0000, "estimated_amount": 48, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 12.73, "estimated_amount": 12, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 8.18, "estimated_amount": 8, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 12.27, "estimated_amount": 12, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 12.73, "estimated_amount": 12, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 40.44, "standard_charge_percentage": 75.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 48.53, "standard_charge_percentage": 90.0000, "estimated_amount": 48, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 21.57, "standard_charge_percentage": 40.0000, "estimated_amount": 21, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 47.18, "standard_charge_percentage": 87.5000, "estimated_amount": 47, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 43.14, "standard_charge_percentage": 80.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 53.92, "standard_charge_percentage": 100.0000, "estimated_amount": 53, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 37.74, "standard_charge_percentage": 70.0000, "estimated_amount": 37, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 37.74, "standard_charge_percentage": 70.0000, "estimated_amount": 37, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 32.35, "standard_charge_percentage": 60.0000, "estimated_amount": 32, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 9.54, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 40.44, "standard_charge_percentage": 75.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 48.53, "standard_charge_percentage": 90.0000, "estimated_amount": 48, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 43.14, "standard_charge_percentage": 80.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 43.14, "standard_charge_percentage": 80.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 53.92, "standard_charge_percentage": 100.0000, "estimated_amount": 53, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 16.18, "standard_charge_percentage": 30.0000, "estimated_amount": 191, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 19.95, "standard_charge_percentage": 37.0000, "estimated_amount": 19, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 43.14, "standard_charge_percentage": 80.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 48.53, "standard_charge_percentage": 90.0000, "estimated_amount": 48, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 40.44, "standard_charge_percentage": 75.0000, "estimated_amount": 40, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 9.54, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 9.09, "estimated_amount": 9, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 18.18, "estimated_amount": 18, "methodology": "fee schedule" }]}]} , { "description": "OBSTETRIC PANEL", "code_information": [ { "code": "36416", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 45.62,"minimum": 13.69,"maximum": 45.62,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 34.22, "standard_charge_percentage": 75.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 34.22, "standard_charge_percentage": 75.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 36.5, "standard_charge_percentage": 80.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 22.81, "standard_charge_percentage": 50.0000, "estimated_amount": 22, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 41.06, "standard_charge_percentage": 90.0000, "estimated_amount": 41, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 41.06, "standard_charge_percentage": 90.0000, "estimated_amount": 41, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 38.78, "standard_charge_percentage": 85.0000, "estimated_amount": 38, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 39.92, "standard_charge_percentage": 87.5000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 36.5, "standard_charge_percentage": 80.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 45.62, "standard_charge_percentage": 100.0000, "estimated_amount": 45, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 45.62, "standard_charge_percentage": 100.0000, "estimated_amount": 45, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 34.22, "standard_charge_percentage": 75.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 31.93, "standard_charge_percentage": 70.0000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 41.06, "standard_charge_percentage": 90.0000, "estimated_amount": 41, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 41.06, "standard_charge_percentage": 90.0000, "estimated_amount": 41, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 27.37, "standard_charge_percentage": 60.0000, "estimated_amount": 27, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 41.06, "standard_charge_percentage": 90.0000, "estimated_amount": 41, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 18.25, "standard_charge_percentage": 40.0000, "estimated_amount": 18, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 43.34, "standard_charge_percentage": 95.0000, "estimated_amount": 43, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 13.69, "standard_charge_percentage": 30.0000, "estimated_amount": 13, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 31.93, "standard_charge_percentage": 70.0000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 26.46, "standard_charge_percentage": 58.0000, "estimated_amount": 26, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 44.71, "standard_charge_percentage": 98.0000, "estimated_amount": 44, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 34.22, "standard_charge_percentage": 75.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 39.92, "standard_charge_percentage": 87.5000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 36.5, "standard_charge_percentage": 80.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 36.5, "standard_charge_percentage": 80.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 27.37, "standard_charge_percentage": 60.0000, "estimated_amount": 27, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 36.5, "standard_charge_percentage": 80.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 36.5, "standard_charge_percentage": 80.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 36.5, "standard_charge_percentage": 80.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 34.22, "standard_charge_percentage": 75.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 16.88, "standard_charge_percentage": 37.0000, "estimated_amount": 16, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 36.5, "standard_charge_percentage": 80.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 36.5, "standard_charge_percentage": 80.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 36.5, "standard_charge_percentage": 80.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 31.93, "standard_charge_percentage": 70.0000, "estimated_amount": 31, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 37.41, "standard_charge_percentage": 82.0000, "estimated_amount": 37, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 25.55, "standard_charge_percentage": 56.0000, "estimated_amount": 25, "methodology": "percent of total billed charges" }]}]} , { "description": "BLOOD(WHOLE)FOR TRANS PER UNIT", "code_information": [ { "code": "36430", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2218.24, "discounted_cash": 534,"minimum": 257.4,"maximum": 2218.24,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 536.67, "estimated_amount": 536, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 257.4, "estimated_amount": 257, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 540.4, "estimated_amount": 540, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 532.95, "estimated_amount": 532, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1996.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1996, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1885.5, "standard_charge_percentage": 85.0000, "estimated_amount": 1885, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1330.94, "standard_charge_percentage": 60.0000, "estimated_amount": 1330, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1774.59, "standard_charge_percentage": 80.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1818.96, "standard_charge_percentage": 82.0000, "estimated_amount": 1818, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1242.21, "standard_charge_percentage": 56.0000, "estimated_amount": 1242, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1286.58, "standard_charge_percentage": 58.0000, "estimated_amount": 1286, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 820.75, "standard_charge_percentage": 37.0000, "estimated_amount": 820, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1774.59, "standard_charge_percentage": 80.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2173.88, "standard_charge_percentage": 98.0000, "estimated_amount": 2173, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 411.26, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1456.22, "estimated_amount": 1456, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 411.26, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 658.02, "estimated_amount": 658, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 372.69, "estimated_amount": 372, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 408.81, "estimated_amount": 408, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1663.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1663, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1774.59, "standard_charge_percentage": 80.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1109.12, "standard_charge_percentage": 50.0000, "estimated_amount": 1109, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1940.96, "standard_charge_percentage": 87.5000, "estimated_amount": 1940, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1940.96, "standard_charge_percentage": 87.5000, "estimated_amount": 1940, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1774.59, "standard_charge_percentage": 80.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1774.59, "standard_charge_percentage": 80.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2107.33, "standard_charge_percentage": 95.0000, "estimated_amount": 2107, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2218.24, "standard_charge_percentage": 100.0000, "estimated_amount": 2218, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1774.59, "standard_charge_percentage": 80.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 665.47, "standard_charge_percentage": 30.0000, "estimated_amount": 665, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1663.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1663, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1552.77, "standard_charge_percentage": 70.0000, "estimated_amount": 1552, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1552.77, "standard_charge_percentage": 70.0000, "estimated_amount": 1552, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1330.94, "standard_charge_percentage": 60.0000, "estimated_amount": 1330, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 411.26, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 431.82, "estimated_amount": 431, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 431.82, "estimated_amount": 431, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 411.26, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 760.83, "estimated_amount": 760, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1774.59, "standard_charge_percentage": 80.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1996.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1996, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2218.24, "standard_charge_percentage": 100.0000, "estimated_amount": 2218, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1996.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1996, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1663.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 411.26, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 411.26, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 575.76, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 575.76, "estimated_amount": 575, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 411.26, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 822.52, "estimated_amount": 822, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 372.69, "estimated_amount": 372, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1663.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1663, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1996.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1996, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 887.3, "standard_charge_percentage": 40.0000, "estimated_amount": 887, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1774.59, "standard_charge_percentage": 80.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1774.59, "standard_charge_percentage": 80.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1774.59, "standard_charge_percentage": 80.0000, "estimated_amount": 1774, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1552.77, "standard_charge_percentage": 70.0000, "estimated_amount": 1552, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1663.68, "standard_charge_percentage": 75.0000, "estimated_amount": 1663, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1996.42, "standard_charge_percentage": 90.0000, "estimated_amount": 1996, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 411.26, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 411.26, "estimated_amount": 411, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 419.49, "estimated_amount": 419, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 555.2, "estimated_amount": 555, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 658.02, "estimated_amount": 658, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 411.26, "estimated_amount": 411, "methodology": "fee schedule" }]}]} , { "description": "PLATELET RICH PLASMA,EA UNIT", "code_information": [ { "code": "36514", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8267.5, "discounted_cash": 2004,"minimum": 382.2,"maximum": 8267.5,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 382.2, "estimated_amount": 382, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1397.46, "estimated_amount": 1397, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6614, "standard_charge_percentage": 80.0000, "estimated_amount": 6614, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7440.75, "standard_charge_percentage": 90.0000, "estimated_amount": 7440, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6614, "standard_charge_percentage": 80.0000, "estimated_amount": 6614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6614, "standard_charge_percentage": 80.0000, "estimated_amount": 6614, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6779.35, "standard_charge_percentage": 82.0000, "estimated_amount": 6779, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8102.15, "standard_charge_percentage": 98.0000, "estimated_amount": 8102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1542.1, "estimated_amount": 1542, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2467.36, "estimated_amount": 2467, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2852.89, "estimated_amount": 2852, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 497.04, "estimated_amount": 497, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1998.37, "estimated_amount": 1998, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6200.63, "standard_charge_percentage": 75.0000, "estimated_amount": 6200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4133.75, "standard_charge_percentage": 50.0000, "estimated_amount": 4133, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3307, "standard_charge_percentage": 40.0000, "estimated_amount": 3307, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6614, "standard_charge_percentage": 80.0000, "estimated_amount": 6614, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8267.5, "standard_charge_percentage": 100.0000, "estimated_amount": 8267, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7854.13, "standard_charge_percentage": 95.0000, "estimated_amount": 7854, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4960.5, "standard_charge_percentage": 60.0000, "estimated_amount": 4960, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6614, "standard_charge_percentage": 80.0000, "estimated_amount": 6614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6200.63, "standard_charge_percentage": 75.0000, "estimated_amount": 6200, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4629.8, "standard_charge_percentage": 56.0000, "estimated_amount": 4629, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4795.15, "standard_charge_percentage": 58.0000, "estimated_amount": 4795, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7440.75, "standard_charge_percentage": 90.0000, "estimated_amount": 7440, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7440.75, "standard_charge_percentage": 90.0000, "estimated_amount": 7440, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1542.1, "estimated_amount": 1542, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1619.2, "estimated_amount": 1619, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1572.94, "estimated_amount": 1572, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1619.2, "estimated_amount": 1619, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2467.36, "estimated_amount": 2467, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1542.1, "estimated_amount": 1542, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3084.2, "estimated_amount": 3084, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 2012.34, "estimated_amount": 2012, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1363.37, "estimated_amount": 1363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2026.32, "estimated_amount": 2026, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6200.63, "standard_charge_percentage": 75.0000, "estimated_amount": 6200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6614, "standard_charge_percentage": 80.0000, "estimated_amount": 6614, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7440.75, "standard_charge_percentage": 90.0000, "estimated_amount": 7440, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7234.06, "standard_charge_percentage": 87.5000, "estimated_amount": 7234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7234.06, "standard_charge_percentage": 87.5000, "estimated_amount": 7234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6614, "standard_charge_percentage": 80.0000, "estimated_amount": 6614, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6614, "standard_charge_percentage": 80.0000, "estimated_amount": 6614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2480.25, "standard_charge_percentage": 30.0000, "estimated_amount": 2480, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5787.25, "standard_charge_percentage": 70.0000, "estimated_amount": 5787, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5787.25, "standard_charge_percentage": 70.0000, "estimated_amount": 5787, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6200.63, "standard_charge_percentage": 75.0000, "estimated_amount": 6200, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1542.1, "estimated_amount": 1542, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5460.37, "estimated_amount": 5460, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1542.1, "estimated_amount": 1542, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2158.94, "estimated_amount": 2158, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1397.46, "estimated_amount": 1397, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7440.75, "standard_charge_percentage": 90.0000, "estimated_amount": 7440, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7027.38, "standard_charge_percentage": 85.0000, "estimated_amount": 7027, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8267.5, "standard_charge_percentage": 100.0000, "estimated_amount": 8267, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6614, "standard_charge_percentage": 80.0000, "estimated_amount": 6614, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5787.25, "standard_charge_percentage": 70.0000, "estimated_amount": 5787, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3058.97, "standard_charge_percentage": 37.0000, "estimated_amount": 3058, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6614, "standard_charge_percentage": 80.0000, "estimated_amount": 6614, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6200.63, "standard_charge_percentage": 75.0000, "estimated_amount": 6200, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4960.5, "standard_charge_percentage": 60.0000, "estimated_amount": 4960, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1542.1, "estimated_amount": 1542, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1542.1, "estimated_amount": 1542, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2158.94, "estimated_amount": 2158, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1542.1, "estimated_amount": 1542, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1542.1, "estimated_amount": 1542, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2081.84, "estimated_amount": 2081, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1542.1, "estimated_amount": 1542, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Non-Tunnel Cv Cath =>5 Yr", "code_information": [ { "code": "36556", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3990.53, "discounted_cash": 3849,"minimum": 382.2,"maximum": 3990.53,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3491.71, "standard_charge_percentage": 87.5000, "estimated_amount": 3491, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3272.23, "standard_charge_percentage": 82.0000, "estimated_amount": 3272, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2314.51, "standard_charge_percentage": 58.0000, "estimated_amount": 2314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 382.2, "estimated_amount": 382, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3491.71, "standard_charge_percentage": 87.5000, "estimated_amount": 3491, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3990.53, "standard_charge_percentage": 100.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3910.72, "standard_charge_percentage": 98.0000, "estimated_amount": 3910, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1995.27, "standard_charge_percentage": 50.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3391.95, "standard_charge_percentage": 85.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1596.21, "standard_charge_percentage": 40.0000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3791, "standard_charge_percentage": 95.0000, "estimated_amount": 3791, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1197.16, "standard_charge_percentage": 30.0000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2394.32, "standard_charge_percentage": 60.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3990.53, "standard_charge_percentage": 100.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2394.32, "standard_charge_percentage": 60.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2234.7, "standard_charge_percentage": 56.0000, "estimated_amount": 2234, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Tunneled Cv Cath W/O Port Or Pump", "code_information": [ { "code": "36558", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9095.15, "discounted_cash": 3849,"minimum": 382.2,"maximum": 9095.15,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 382.2, "estimated_amount": 382, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4547.57, "standard_charge_percentage": 50.0000, "estimated_amount": 4547, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7730.88, "standard_charge_percentage": 85.0000, "estimated_amount": 7730, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2728.55, "standard_charge_percentage": 30.0000, "estimated_amount": 2728, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7458.02, "standard_charge_percentage": 82.0000, "estimated_amount": 7458, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5093.28, "standard_charge_percentage": 56.0000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5275.19, "standard_charge_percentage": 58.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5457.09, "standard_charge_percentage": 60.0000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7958.26, "standard_charge_percentage": 87.5000, "estimated_amount": 7958, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5457.09, "standard_charge_percentage": 60.0000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3638.06, "standard_charge_percentage": 40.0000, "estimated_amount": 3638, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7958.26, "standard_charge_percentage": 87.5000, "estimated_amount": 7958, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8640.39, "standard_charge_percentage": 95.0000, "estimated_amount": 8640, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8913.25, "standard_charge_percentage": 98.0000, "estimated_amount": 8913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9095.15, "standard_charge_percentage": 100.0000, "estimated_amount": 9095, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9095.15, "standard_charge_percentage": 100.0000, "estimated_amount": 9095, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9095.15, "estimated_amount": 9095, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Tunneled Cv Cath With Port", "code_information": [ { "code": "36561", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9095.15, "discounted_cash": 3849,"minimum": 945.83,"maximum": 9095.15,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4547.57, "standard_charge_percentage": 50.0000, "estimated_amount": 4547, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7958.26, "standard_charge_percentage": 87.5000, "estimated_amount": 7958, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8640.39, "standard_charge_percentage": 95.0000, "estimated_amount": 8640, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8913.25, "standard_charge_percentage": 98.0000, "estimated_amount": 8913, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "case rate" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3638.06, "standard_charge_percentage": 40.0000, "estimated_amount": 3638, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5457.09, "standard_charge_percentage": 60.0000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9095.15, "estimated_amount": 9095, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9095.15, "standard_charge_percentage": 100.0000, "estimated_amount": 9095, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9095.15, "standard_charge_percentage": 100.0000, "estimated_amount": 9095, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5093.28, "standard_charge_percentage": 56.0000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 945.83, "estimated_amount": 945, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7730.88, "standard_charge_percentage": 85.0000, "estimated_amount": 7730, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7958.26, "standard_charge_percentage": 87.5000, "estimated_amount": 7958, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2728.55, "standard_charge_percentage": 30.0000, "estimated_amount": 2728, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7458.02, "standard_charge_percentage": 82.0000, "estimated_amount": 7458, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5275.19, "standard_charge_percentage": 58.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5457.09, "standard_charge_percentage": 60.0000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" }]}]} , { "description": "Hc Insj Prph Cvc W/O Subq Port/Pmp Age 5 Yr/>", "code_information": [ { "code": "36569", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3586.66, "discounted_cash": 1899,"minimum": 702,"maximum": 3586.66,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 3211, "estimated_amount": 3211, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3048.66, "standard_charge_percentage": 85.0000, "estimated_amount": 3048, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3586.66, "standard_charge_percentage": 100.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3407.33, "standard_charge_percentage": 95.0000, "estimated_amount": 3407, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2152, "standard_charge_percentage": 60.0000, "estimated_amount": 2152, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1076, "standard_charge_percentage": 30.0000, "estimated_amount": 1076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2008.53, "standard_charge_percentage": 56.0000, "estimated_amount": 2008, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2152, "standard_charge_percentage": 60.0000, "estimated_amount": 2152, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1793.33, "standard_charge_percentage": 50.0000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3514.93, "standard_charge_percentage": 98.0000, "estimated_amount": 3514, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1490.58, "estimated_amount": 1490, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1972.82, "estimated_amount": 1972, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1793.33, "standard_charge_percentage": 50.0000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3514.93, "standard_charge_percentage": 98.0000, "estimated_amount": 3514, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3048.66, "standard_charge_percentage": 85.0000, "estimated_amount": 3048, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3138.33, "standard_charge_percentage": 87.5000, "estimated_amount": 3138, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3586.66, "standard_charge_percentage": 100.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2152, "standard_charge_percentage": 60.0000, "estimated_amount": 2152, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1076, "standard_charge_percentage": 30.0000, "estimated_amount": 1076, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2941.06, "standard_charge_percentage": 82.0000, "estimated_amount": 2941, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2080.26, "standard_charge_percentage": 58.0000, "estimated_amount": 2080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 3211, "estimated_amount": 3211, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1434.66, "standard_charge_percentage": 40.0000, "estimated_amount": 1434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3138.33, "standard_charge_percentage": 87.5000, "estimated_amount": 3138, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3138.33, "standard_charge_percentage": 87.5000, "estimated_amount": 3138, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3586.66, "standard_charge_percentage": 100.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2941.06, "standard_charge_percentage": 82.0000, "estimated_amount": 2941, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1434.66, "standard_charge_percentage": 40.0000, "estimated_amount": 1434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3138.33, "standard_charge_percentage": 87.5000, "estimated_amount": 3138, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3586.66, "standard_charge_percentage": 100.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2703.5, "estimated_amount": 2703, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2080.26, "standard_charge_percentage": 58.0000, "estimated_amount": 2080, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3407.33, "standard_charge_percentage": 95.0000, "estimated_amount": 3407, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2008.53, "standard_charge_percentage": 56.0000, "estimated_amount": 2008, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2152, "standard_charge_percentage": 60.0000, "estimated_amount": 2152, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 3586.66, "estimated_amount": 3586, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2922.7, "estimated_amount": 2922, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Picc W/ Sub-Q Port", "code_information": [ { "code": "36571", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 15737.5, "discounted_cash": 3849,"minimum": 1123,"maximum": 15737.5,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 13376.9, "standard_charge_percentage": 85.0000, "estimated_amount": 13376, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 13770.3, "standard_charge_percentage": 87.5000, "estimated_amount": 13770, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 15737.5, "standard_charge_percentage": 100.0000, "estimated_amount": 15737, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 12590, "standard_charge_percentage": 80.0000, "estimated_amount": 12590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 11803.1, "standard_charge_percentage": 75.0000, "estimated_amount": 11803, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 11016.3, "standard_charge_percentage": 70.0000, "estimated_amount": 11016, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 11803.1, "standard_charge_percentage": 75.0000, "estimated_amount": 11803, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 15422.8, "standard_charge_percentage": 98.0000, "estimated_amount": 15422, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 10484.2, "estimated_amount": 10484, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 3211, "estimated_amount": 3211, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1123, "estimated_amount": 1123, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12590, "standard_charge_percentage": 80.0000, "estimated_amount": 12590, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 7868.75, "standard_charge_percentage": 50.0000, "estimated_amount": 7868, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 14163.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12590, "standard_charge_percentage": 80.0000, "estimated_amount": 12590, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 12590, "standard_charge_percentage": 80.0000, "estimated_amount": 12590, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 12590, "standard_charge_percentage": 80.0000, "estimated_amount": 12590, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 11016.3, "standard_charge_percentage": 70.0000, "estimated_amount": 11016, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 11803.1, "standard_charge_percentage": 75.0000, "estimated_amount": 11803, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 12590, "standard_charge_percentage": 80.0000, "estimated_amount": 12590, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 11803.1, "standard_charge_percentage": 75.0000, "estimated_amount": 11803, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 14163.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14163, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6295, "standard_charge_percentage": 40.0000, "estimated_amount": 6295, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 13770.3, "standard_charge_percentage": 87.5000, "estimated_amount": 13770, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 14950.6, "standard_charge_percentage": 95.0000, "estimated_amount": 14950, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 9442.5, "standard_charge_percentage": 60.0000, "estimated_amount": 9442, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4721.25, "standard_charge_percentage": 30.0000, "estimated_amount": 4721, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 12904.8, "standard_charge_percentage": 82.0000, "estimated_amount": 12904, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8813, "standard_charge_percentage": 56.0000, "estimated_amount": 8813, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9127.75, "standard_charge_percentage": 58.0000, "estimated_amount": 9127, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 11803.1, "standard_charge_percentage": 75.0000, "estimated_amount": 11803, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 14163.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14163, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 12590, "standard_charge_percentage": 80.0000, "estimated_amount": 12590, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 12590, "standard_charge_percentage": 80.0000, "estimated_amount": 12590, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 12590, "standard_charge_percentage": 80.0000, "estimated_amount": 12590, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 15737.5, "standard_charge_percentage": 100.0000, "estimated_amount": 15737, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 11016.3, "standard_charge_percentage": 70.0000, "estimated_amount": 11016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12590, "standard_charge_percentage": 80.0000, "estimated_amount": 12590, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 14163.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14163, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 14163.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14163, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 9442.5, "standard_charge_percentage": 60.0000, "estimated_amount": 9442, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" }]}]} , { "description": "Hc Ins Picc Rs&I W/O Port 5Yr+", "code_information": [ { "code": "36573", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9918.96, "discounted_cash": 1899,"minimum": 710.86,"maximum": 9918.96,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 710.86, "estimated_amount": 710, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 710.86, "estimated_amount": 710, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7935.17, "standard_charge_percentage": 80.0000, "estimated_amount": 7935, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3967.58, "standard_charge_percentage": 40.0000, "estimated_amount": 3967, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8679.09, "standard_charge_percentage": 87.5000, "estimated_amount": 8679, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7935.17, "standard_charge_percentage": 80.0000, "estimated_amount": 7935, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9918.96, "standard_charge_percentage": 100.0000, "estimated_amount": 9918, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7935.17, "standard_charge_percentage": 80.0000, "estimated_amount": 7935, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2975.69, "standard_charge_percentage": 30.0000, "estimated_amount": 2975, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6943.27, "standard_charge_percentage": 70.0000, "estimated_amount": 6943, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8927.06, "standard_charge_percentage": 90.0000, "estimated_amount": 8927, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7439.22, "standard_charge_percentage": 75.0000, "estimated_amount": 7439, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1490.58, "estimated_amount": 1490, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2703.5, "estimated_amount": 2703, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2922.7, "estimated_amount": 2922, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7439.22, "standard_charge_percentage": 75.0000, "estimated_amount": 7439, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8927.06, "standard_charge_percentage": 90.0000, "estimated_amount": 8927, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8927.06, "standard_charge_percentage": 90.0000, "estimated_amount": 8927, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 8431.12, "standard_charge_percentage": 85.0000, "estimated_amount": 8431, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 9423.01, "standard_charge_percentage": 95.0000, "estimated_amount": 9423, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5951.38, "standard_charge_percentage": 60.0000, "estimated_amount": 5951, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6943.27, "standard_charge_percentage": 70.0000, "estimated_amount": 6943, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5554.62, "standard_charge_percentage": 56.0000, "estimated_amount": 5554, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5753, "standard_charge_percentage": 58.0000, "estimated_amount": 5753, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7439.22, "standard_charge_percentage": 75.0000, "estimated_amount": 7439, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9918.96, "standard_charge_percentage": 100.0000, "estimated_amount": 9918, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7935.17, "standard_charge_percentage": 80.0000, "estimated_amount": 7935, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7935.17, "standard_charge_percentage": 80.0000, "estimated_amount": 7935, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7935.17, "standard_charge_percentage": 80.0000, "estimated_amount": 7935, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 8133.55, "standard_charge_percentage": 82.0000, "estimated_amount": 8133, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9720.58, "standard_charge_percentage": 98.0000, "estimated_amount": 9720, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5951.38, "standard_charge_percentage": 60.0000, "estimated_amount": 5951, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5174.45, "estimated_amount": 5174, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7935.17, "standard_charge_percentage": 80.0000, "estimated_amount": 7935, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4959.48, "standard_charge_percentage": 50.0000, "estimated_amount": 4959, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8927.06, "standard_charge_percentage": 90.0000, "estimated_amount": 8927, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8679.09, "standard_charge_percentage": 87.5000, "estimated_amount": 8679, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7935.17, "standard_charge_percentage": 80.0000, "estimated_amount": 7935, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7935.17, "standard_charge_percentage": 80.0000, "estimated_amount": 7935, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7439.22, "standard_charge_percentage": 75.0000, "estimated_amount": 7439, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6943.27, "standard_charge_percentage": 70.0000, "estimated_amount": 6943, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7439.22, "standard_charge_percentage": 75.0000, "estimated_amount": 7439, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3670.02, "standard_charge_percentage": 37.0000, "estimated_amount": 3670, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7935.17, "standard_charge_percentage": 80.0000, "estimated_amount": 7935, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8927.06, "standard_charge_percentage": 90.0000, "estimated_amount": 8927, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1972.82, "estimated_amount": 1972, "methodology": "fee schedule" }]}]} , { "description": "Hc Replace Cv Cath Cmplt Nontunnld Wo Subq Port/Pump", "code_information": [ { "code": "36580", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3586.66, "discounted_cash": 1899,"minimum": 423.81,"maximum": 3586.66,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1434.66, "standard_charge_percentage": 40.0000, "estimated_amount": 1434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3138.33, "standard_charge_percentage": 87.5000, "estimated_amount": 3138, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3138.33, "standard_charge_percentage": 87.5000, "estimated_amount": 3138, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3586.66, "standard_charge_percentage": 100.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 2941.06, "standard_charge_percentage": 82.0000, "estimated_amount": 2941, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2080.26, "standard_charge_percentage": 58.0000, "estimated_amount": 2080, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1972.82, "estimated_amount": 1972, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 423.81, "estimated_amount": 423, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 3586.66, "estimated_amount": 3586, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2703.5, "estimated_amount": 2703, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1793.33, "standard_charge_percentage": 50.0000, "estimated_amount": 1793, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3586.66, "standard_charge_percentage": 100.0000, "estimated_amount": 3586, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1076, "standard_charge_percentage": 30.0000, "estimated_amount": 1076, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1490.58, "estimated_amount": 1490, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2922.7, "estimated_amount": 2922, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2689.99, "standard_charge_percentage": 75.0000, "estimated_amount": 2689, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3227.99, "standard_charge_percentage": 90.0000, "estimated_amount": 3227, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3048.66, "standard_charge_percentage": 85.0000, "estimated_amount": 3048, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3407.33, "standard_charge_percentage": 95.0000, "estimated_amount": 3407, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2152, "standard_charge_percentage": 60.0000, "estimated_amount": 2152, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2510.66, "standard_charge_percentage": 70.0000, "estimated_amount": 2510, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2008.53, "standard_charge_percentage": 56.0000, "estimated_amount": 2008, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 2869.33, "standard_charge_percentage": 80.0000, "estimated_amount": 2869, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3514.93, "standard_charge_percentage": 98.0000, "estimated_amount": 3514, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2152, "standard_charge_percentage": 60.0000, "estimated_amount": 2152, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" }]}]} , { "description": "Hc Rplc Cv Cath Cmplt Tunld Wo Subq Port/Pump", "code_information": [ { "code": "36581", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9095.15, "discounted_cash": 3849,"minimum": 423.81,"maximum": 9095.15,"payers_information":[{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 7958.26, "standard_charge_percentage": 87.5000, "estimated_amount": 7958, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5457.09, "standard_charge_percentage": 60.0000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4547.57, "standard_charge_percentage": 50.0000, "estimated_amount": 4547, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 7730.88, "standard_charge_percentage": 85.0000, "estimated_amount": 7730, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 7958.26, "standard_charge_percentage": 87.5000, "estimated_amount": 7958, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2728.55, "standard_charge_percentage": 30.0000, "estimated_amount": 2728, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7458.02, "standard_charge_percentage": 82.0000, "estimated_amount": 7458, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5093.28, "standard_charge_percentage": 56.0000, "estimated_amount": 5093, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5275.19, "standard_charge_percentage": 58.0000, "estimated_amount": 5275, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8185.64, "standard_charge_percentage": 90.0000, "estimated_amount": 8185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5457.09, "standard_charge_percentage": 60.0000, "estimated_amount": 5457, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9095.15, "standard_charge_percentage": 100.0000, "estimated_amount": 9095, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9095.15, "standard_charge_percentage": 100.0000, "estimated_amount": 9095, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 423.81, "estimated_amount": 423, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6821.36, "standard_charge_percentage": 75.0000, "estimated_amount": 6821, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3638.06, "standard_charge_percentage": 40.0000, "estimated_amount": 3638, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7276.12, "standard_charge_percentage": 80.0000, "estimated_amount": 7276, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 8640.39, "standard_charge_percentage": 95.0000, "estimated_amount": 8640, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6366.6, "standard_charge_percentage": 70.0000, "estimated_amount": 6366, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 8913.25, "standard_charge_percentage": 98.0000, "estimated_amount": 8913, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9095.15, "estimated_amount": 9095, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" }]}]} , { "description": "Hc Replace Picc Wo Port/Pump", "code_information": [ { "code": "36584", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7858.54, "discounted_cash": 1899,"minimum": 423.81,"maximum": 7858.54,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3143.42, "standard_charge_percentage": 40.0000, "estimated_amount": 3143, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6286.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6286, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6286.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6286, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6286.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6286, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5174.45, "estimated_amount": 5174, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1490.58, "estimated_amount": 1490, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2922.7, "estimated_amount": 2922, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 423.81, "estimated_amount": 423, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5893.9, "standard_charge_percentage": 75.0000, "estimated_amount": 5893, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6679.76, "standard_charge_percentage": 85.0000, "estimated_amount": 6679, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6286.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6286, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6286.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6286, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7858.54, "standard_charge_percentage": 100.0000, "estimated_amount": 7858, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7465.61, "standard_charge_percentage": 95.0000, "estimated_amount": 7465, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4715.12, "standard_charge_percentage": 60.0000, "estimated_amount": 4715, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6286.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6286, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5893.9, "standard_charge_percentage": 75.0000, "estimated_amount": 5893, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5893.9, "standard_charge_percentage": 75.0000, "estimated_amount": 5893, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4557.95, "standard_charge_percentage": 58.0000, "estimated_amount": 4557, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7072.69, "standard_charge_percentage": 90.0000, "estimated_amount": 7072, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7072.69, "standard_charge_percentage": 90.0000, "estimated_amount": 7072, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2703.5, "estimated_amount": 2703, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5893.9, "standard_charge_percentage": 75.0000, "estimated_amount": 5893, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3929.27, "standard_charge_percentage": 50.0000, "estimated_amount": 3929, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7072.69, "standard_charge_percentage": 90.0000, "estimated_amount": 7072, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6286.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6286, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2357.56, "standard_charge_percentage": 30.0000, "estimated_amount": 2357, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6444, "standard_charge_percentage": 82.0000, "estimated_amount": 6444, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7701.37, "standard_charge_percentage": 98.0000, "estimated_amount": 7701, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6286.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6286, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6286.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6286, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7072.69, "standard_charge_percentage": 90.0000, "estimated_amount": 7072, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7072.69, "standard_charge_percentage": 90.0000, "estimated_amount": 7072, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6876.22, "standard_charge_percentage": 87.5000, "estimated_amount": 6876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6876.22, "standard_charge_percentage": 87.5000, "estimated_amount": 6876, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7858.54, "standard_charge_percentage": 100.0000, "estimated_amount": 7858, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6286.83, "standard_charge_percentage": 80.0000, "estimated_amount": 6286, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5500.98, "standard_charge_percentage": 70.0000, "estimated_amount": 5500, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5500.98, "standard_charge_percentage": 70.0000, "estimated_amount": 5500, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5500.98, "standard_charge_percentage": 70.0000, "estimated_amount": 5500, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4400.78, "standard_charge_percentage": 56.0000, "estimated_amount": 4400, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5893.9, "standard_charge_percentage": 75.0000, "estimated_amount": 5893, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4715.12, "standard_charge_percentage": 60.0000, "estimated_amount": 4715, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1972.82, "estimated_amount": 1972, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" }]}]} , { "description": "Hc Removal Tunneled Cv Cath W/O Subq Port Or Pump", "code_information": [ { "code": "36589", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2236.21, "discounted_cash": 756,"minimum": 163.98,"maximum": 2236.21,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 764.24, "estimated_amount": 764, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2012.59, "standard_charge_percentage": 90.0000, "estimated_amount": 2012, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 894.48, "standard_charge_percentage": 40.0000, "estimated_amount": 894, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1956.68, "standard_charge_percentage": 87.5000, "estimated_amount": 1956, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2236.21, "standard_charge_percentage": 100.0000, "estimated_amount": 2236, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1341.73, "standard_charge_percentage": 60.0000, "estimated_amount": 1341, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1677.16, "standard_charge_percentage": 75.0000, "estimated_amount": 1677, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1565.35, "standard_charge_percentage": 70.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1252.28, "standard_charge_percentage": 56.0000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1677.16, "standard_charge_percentage": 75.0000, "estimated_amount": 1677, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 163.98, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 527.06, "estimated_amount": 527, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1677.16, "standard_charge_percentage": 75.0000, "estimated_amount": 1677, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1118.11, "standard_charge_percentage": 50.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2012.59, "standard_charge_percentage": 90.0000, "estimated_amount": 2012, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1900.78, "standard_charge_percentage": 85.0000, "estimated_amount": 1900, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1956.68, "standard_charge_percentage": 87.5000, "estimated_amount": 1956, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2124.4, "standard_charge_percentage": 95.0000, "estimated_amount": 2124, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1565.35, "standard_charge_percentage": 70.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1297, "standard_charge_percentage": 58.0000, "estimated_amount": 1297, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2012.59, "standard_charge_percentage": 90.0000, "estimated_amount": 2012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1341.73, "standard_charge_percentage": 60.0000, "estimated_amount": 1341, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 610.68, "estimated_amount": 610, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 758.97, "estimated_amount": 758, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 753.7, "estimated_amount": 753, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2012.59, "standard_charge_percentage": 90.0000, "estimated_amount": 2012, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1565.35, "standard_charge_percentage": 70.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2012.59, "standard_charge_percentage": 90.0000, "estimated_amount": 2012, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2191.49, "standard_charge_percentage": 98.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 785.16, "estimated_amount": 785, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 1075.96, "estimated_amount": 1075, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 1163.2, "estimated_amount": 1163, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 580.01, "estimated_amount": 580, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1677.16, "standard_charge_percentage": 75.0000, "estimated_amount": 1677, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2236.21, "standard_charge_percentage": 100.0000, "estimated_amount": 2236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 670.86, "standard_charge_percentage": 30.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1677.16, "standard_charge_percentage": 75.0000, "estimated_amount": 1677, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1833.69, "standard_charge_percentage": 82.0000, "estimated_amount": 1833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 581.6, "estimated_amount": 581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2059.37, "estimated_amount": 2059, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 593.23, "estimated_amount": 593, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 814.24, "estimated_amount": 814, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 930.56, "estimated_amount": 930, "methodology": "fee schedule" }]}]} , { "description": "Hc Removal Tunld Cv Cath W Subq Port/Pump", "code_information": [ { "code": "36590", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 2236.21, "discounted_cash": 1899,"minimum": 275.54,"maximum": 2236.21,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 2012.59, "standard_charge_percentage": 90.0000, "estimated_amount": 2012, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 894.48, "standard_charge_percentage": 40.0000, "estimated_amount": 894, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1956.68, "standard_charge_percentage": 87.5000, "estimated_amount": 1956, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 2236.21, "standard_charge_percentage": 100.0000, "estimated_amount": 2236, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1341.73, "standard_charge_percentage": 60.0000, "estimated_amount": 1341, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1677.16, "standard_charge_percentage": 75.0000, "estimated_amount": 1677, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1565.35, "standard_charge_percentage": 70.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 1252.28, "standard_charge_percentage": 56.0000, "estimated_amount": 1252, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1677.16, "standard_charge_percentage": 75.0000, "estimated_amount": 1677, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 2236.21, "estimated_amount": 2236, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 275.54, "estimated_amount": 275, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1677.16, "standard_charge_percentage": 75.0000, "estimated_amount": 1677, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 2012.59, "standard_charge_percentage": 90.0000, "estimated_amount": 2012, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1900.78, "standard_charge_percentage": 85.0000, "estimated_amount": 1900, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 2124.4, "standard_charge_percentage": 95.0000, "estimated_amount": 2124, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1565.35, "standard_charge_percentage": 70.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 2012.59, "standard_charge_percentage": 90.0000, "estimated_amount": 2012, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1341.73, "standard_charge_percentage": 60.0000, "estimated_amount": 1341, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1490.58, "estimated_amount": 1490, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2236.21, "estimated_amount": 2236, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1118.11, "standard_charge_percentage": 50.0000, "estimated_amount": 1118, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 2012.59, "standard_charge_percentage": 90.0000, "estimated_amount": 2012, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1956.68, "standard_charge_percentage": 87.5000, "estimated_amount": 1956, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1565.35, "standard_charge_percentage": 70.0000, "estimated_amount": 1565, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 1297, "standard_charge_percentage": 58.0000, "estimated_amount": 1297, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 2012.59, "standard_charge_percentage": 90.0000, "estimated_amount": 2012, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 2191.49, "standard_charge_percentage": 98.0000, "estimated_amount": 2191, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1972.82, "estimated_amount": 1972, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2236.21, "estimated_amount": 2236, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2236.21, "estimated_amount": 2236, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 702, "estimated_amount": 702, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1677.16, "standard_charge_percentage": 75.0000, "estimated_amount": 1677, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 2236.21, "standard_charge_percentage": 100.0000, "estimated_amount": 2236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 670.86, "standard_charge_percentage": 30.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1677.16, "standard_charge_percentage": 75.0000, "estimated_amount": 1677, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1833.69, "standard_charge_percentage": 82.0000, "estimated_amount": 1833, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1788.97, "standard_charge_percentage": 80.0000, "estimated_amount": 1788, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2236.21, "estimated_amount": 2236, "methodology": "fee schedule" }]}]} , { "description": "ELUTION AB, EACH", "code_information": [ { "code": "36591", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 220.3, "discounted_cash": 157,"minimum": 66.09,"maximum": 220.3,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 198.27, "standard_charge_percentage": 90.0000, "estimated_amount": 198, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 187.25, "standard_charge_percentage": 85.0000, "estimated_amount": 187, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 176.24, "standard_charge_percentage": 80.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 176.24, "standard_charge_percentage": 80.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 176.24, "standard_charge_percentage": 80.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 176.24, "standard_charge_percentage": 80.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 154.21, "standard_charge_percentage": 70.0000, "estimated_amount": 154, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 81.51, "standard_charge_percentage": 37.0000, "estimated_amount": 81, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 198.27, "standard_charge_percentage": 90.0000, "estimated_amount": 198, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 165.22, "standard_charge_percentage": 75.0000, "estimated_amount": 165, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 110.15, "standard_charge_percentage": 50.0000, "estimated_amount": 110, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 71.01, "estimated_amount": 71, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 176.24, "standard_charge_percentage": 80.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 176.24, "standard_charge_percentage": 80.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 110.15, "standard_charge_percentage": 50.0000, "estimated_amount": 110, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 198.27, "standard_charge_percentage": 90.0000, "estimated_amount": 198, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 176.24, "standard_charge_percentage": 80.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 66.09, "standard_charge_percentage": 30.0000, "estimated_amount": 66, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 165.22, "standard_charge_percentage": 75.0000, "estimated_amount": 165, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 154.21, "standard_charge_percentage": 70.0000, "estimated_amount": 154, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 154.21, "standard_charge_percentage": 70.0000, "estimated_amount": 154, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 165.22, "standard_charge_percentage": 75.0000, "estimated_amount": 165, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 220.3, "estimated_amount": 220, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 165.22, "standard_charge_percentage": 75.0000, "estimated_amount": 165, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 192.76, "standard_charge_percentage": 87.5000, "estimated_amount": 192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 192.76, "standard_charge_percentage": 87.5000, "estimated_amount": 192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 209.28, "standard_charge_percentage": 95.0000, "estimated_amount": 209, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 220.3, "standard_charge_percentage": 100.0000, "estimated_amount": 220, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 132.18, "standard_charge_percentage": 60.0000, "estimated_amount": 132, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 180.65, "standard_charge_percentage": 82.0000, "estimated_amount": 180, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 123.37, "standard_charge_percentage": 56.0000, "estimated_amount": 123, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 127.77, "standard_charge_percentage": 58.0000, "estimated_amount": 127, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 176.24, "standard_charge_percentage": 80.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 198.27, "standard_charge_percentage": 90.0000, "estimated_amount": 198, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 132.18, "standard_charge_percentage": 60.0000, "estimated_amount": 132, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 165.22, "standard_charge_percentage": 75.0000, "estimated_amount": 165, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 198.27, "standard_charge_percentage": 90.0000, "estimated_amount": 198, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 88.12, "standard_charge_percentage": 40.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 176.24, "standard_charge_percentage": 80.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 176.24, "standard_charge_percentage": 80.0000, "estimated_amount": 176, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 220.3, "standard_charge_percentage": 100.0000, "estimated_amount": 220, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 215.89, "standard_charge_percentage": 98.0000, "estimated_amount": 215, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 220.3, "estimated_amount": 220, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 220.3, "estimated_amount": 220, "methodology": "fee schedule" }]}]} , { "description": "CAPILLARY SPECIMEN COLLECTION", "code_information": [ { "code": "36592", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 609.26, "discounted_cash": 157,"minimum": 71.01,"maximum": 609.26,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 456.94, "standard_charge_percentage": 75.0000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 548.33, "standard_charge_percentage": 90.0000, "estimated_amount": 548, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 487.41, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 578.8, "standard_charge_percentage": 95.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 426.48, "standard_charge_percentage": 70.0000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 456.94, "standard_charge_percentage": 75.0000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 499.59, "standard_charge_percentage": 82.0000, "estimated_amount": 499, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 548.33, "standard_charge_percentage": 90.0000, "estimated_amount": 548, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 597.07, "standard_charge_percentage": 98.0000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 365.56, "standard_charge_percentage": 60.0000, "estimated_amount": 365, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 429.33, "estimated_amount": 429, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 487.41, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 487.41, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 548.33, "standard_charge_percentage": 90.0000, "estimated_amount": 548, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 533.1, "standard_charge_percentage": 87.5000, "estimated_amount": 533, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 487.41, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 609.26, "standard_charge_percentage": 100.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 487.41, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 182.78, "standard_charge_percentage": 30.0000, "estimated_amount": 182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 456.94, "standard_charge_percentage": 75.0000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 487.41, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 456.94, "standard_charge_percentage": 75.0000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 304.63, "standard_charge_percentage": 50.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 71.01, "estimated_amount": 71, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 533.1, "standard_charge_percentage": 87.5000, "estimated_amount": 533, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 487.41, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 609.26, "standard_charge_percentage": 100.0000, "estimated_amount": 609, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 487.41, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 426.48, "standard_charge_percentage": 70.0000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 353.37, "standard_charge_percentage": 58.0000, "estimated_amount": 353, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 548.33, "standard_charge_percentage": 90.0000, "estimated_amount": 548, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 456.94, "standard_charge_percentage": 75.0000, "estimated_amount": 456, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 304.63, "standard_charge_percentage": 50.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 548.33, "standard_charge_percentage": 90.0000, "estimated_amount": 548, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 517.87, "standard_charge_percentage": 85.0000, "estimated_amount": 517, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 243.7, "standard_charge_percentage": 40.0000, "estimated_amount": 243, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 365.56, "standard_charge_percentage": 60.0000, "estimated_amount": 365, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 487.41, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 487.41, "standard_charge_percentage": 80.0000, "estimated_amount": 487, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 426.48, "standard_charge_percentage": 70.0000, "estimated_amount": 426, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 341.19, "standard_charge_percentage": 56.0000, "estimated_amount": 341, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 225.43, "standard_charge_percentage": 37.0000, "estimated_amount": 225, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" }]}]} , { "description": "Hc Declot Thrombolytic Agent Implant Dev/Cath", "code_information": [ { "code": "36593", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 705.62, "discounted_cash": 405,"minimum": 27.4,"maximum": 705.62,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 407.17, "estimated_amount": 407, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 529.22, "standard_charge_percentage": 75.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 564.5, "standard_charge_percentage": 80.0000, "estimated_amount": 564, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 635.06, "standard_charge_percentage": 90.0000, "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 617.42, "standard_charge_percentage": 87.5000, "estimated_amount": 617, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 564.5, "standard_charge_percentage": 80.0000, "estimated_amount": 564, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 564.5, "standard_charge_percentage": 80.0000, "estimated_amount": 564, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 211.69, "standard_charge_percentage": 30.0000, "estimated_amount": 211, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 261.08, "standard_charge_percentage": 37.0000, "estimated_amount": 261, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 529.22, "standard_charge_percentage": 75.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 318.26, "estimated_amount": 318, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 499.23, "estimated_amount": 499, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 27.4, "estimated_amount": 27, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 705.62, "estimated_amount": 705, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 529.22, "standard_charge_percentage": 75.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 352.81, "standard_charge_percentage": 50.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 282.25, "standard_charge_percentage": 40.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 670.34, "standard_charge_percentage": 95.0000, "estimated_amount": 670, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 493.93, "standard_charge_percentage": 70.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 395.15, "standard_charge_percentage": 56.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 564.5, "standard_charge_percentage": 80.0000, "estimated_amount": 564, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 635.06, "standard_charge_percentage": 90.0000, "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 705.62, "estimated_amount": 705, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 421.23, "estimated_amount": 421, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 436.83, "estimated_amount": 436, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 577.24, "estimated_amount": 577, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 624.04, "estimated_amount": 624, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 404.35, "estimated_amount": 404, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 635.06, "standard_charge_percentage": 90.0000, "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 564.5, "standard_charge_percentage": 80.0000, "estimated_amount": 564, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 705.62, "standard_charge_percentage": 100.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 564.5, "standard_charge_percentage": 80.0000, "estimated_amount": 564, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 564.5, "standard_charge_percentage": 80.0000, "estimated_amount": 564, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 564.5, "standard_charge_percentage": 80.0000, "estimated_amount": 564, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 493.93, "standard_charge_percentage": 70.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 635.06, "standard_charge_percentage": 90.0000, "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 691.51, "standard_charge_percentage": 98.0000, "estimated_amount": 691, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 423.37, "standard_charge_percentage": 60.0000, "estimated_amount": 423, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 327.62, "estimated_amount": 327, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 282.76, "estimated_amount": 282, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 333.48, "estimated_amount": 333, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 282.76, "estimated_amount": 282, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 410, "estimated_amount": 410, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 564.5, "standard_charge_percentage": 80.0000, "estimated_amount": 564, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 635.06, "standard_charge_percentage": 90.0000, "estimated_amount": 635, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 599.78, "standard_charge_percentage": 85.0000, "estimated_amount": 599, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 617.42, "standard_charge_percentage": 87.5000, "estimated_amount": 617, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 705.62, "standard_charge_percentage": 100.0000, "estimated_amount": 705, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 423.37, "standard_charge_percentage": 60.0000, "estimated_amount": 423, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 564.5, "standard_charge_percentage": 80.0000, "estimated_amount": 564, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 529.22, "standard_charge_percentage": 75.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 493.93, "standard_charge_percentage": 70.0000, "estimated_amount": 493, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 529.22, "standard_charge_percentage": 75.0000, "estimated_amount": 529, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 578.61, "standard_charge_percentage": 82.0000, "estimated_amount": 578, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 409.26, "standard_charge_percentage": 58.0000, "estimated_amount": 409, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 436.83, "estimated_amount": 436, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 499.23, "estimated_amount": 499, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 327.62, "estimated_amount": 327, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" }]}]} , { "description": "Hc Mech Remov Pericath Obstr Cv Dev Via Ven Access", "code_information": [ { "code": "36595", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9639, "discounted_cash": 3849,"minimum": 382.2,"maximum": 9639,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8434.13, "standard_charge_percentage": 87.5000, "estimated_amount": 8434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8434.13, "standard_charge_percentage": 87.5000, "estimated_amount": 8434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9639, "standard_charge_percentage": 100.0000, "estimated_amount": 9639, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5783.4, "standard_charge_percentage": 60.0000, "estimated_amount": 5783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2891.7, "standard_charge_percentage": 30.0000, "estimated_amount": 2891, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7903.98, "standard_charge_percentage": 82.0000, "estimated_amount": 7903, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5397.84, "standard_charge_percentage": 56.0000, "estimated_amount": 5397, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3566.43, "standard_charge_percentage": 37.0000, "estimated_amount": 3566, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 382.2, "estimated_amount": 382, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3855.6, "standard_charge_percentage": 40.0000, "estimated_amount": 3855, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9639, "estimated_amount": 9639, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4819.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4819, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 9157.05, "standard_charge_percentage": 95.0000, "estimated_amount": 9157, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5590.62, "standard_charge_percentage": 58.0000, "estimated_amount": 5590, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5783.4, "standard_charge_percentage": 60.0000, "estimated_amount": 5783, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 8193.15, "standard_charge_percentage": 85.0000, "estimated_amount": 8193, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9639, "standard_charge_percentage": 100.0000, "estimated_amount": 9639, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9446.22, "standard_charge_percentage": 98.0000, "estimated_amount": 9446, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "36597", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7629.65, "discounted_cash": 1899,"minimum": 382.2,"maximum": 7629.65,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6103.72, "standard_charge_percentage": 80.0000, "estimated_amount": 6103, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5722.24, "standard_charge_percentage": 75.0000, "estimated_amount": 5722, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6103.72, "standard_charge_percentage": 80.0000, "estimated_amount": 6103, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7629.65, "standard_charge_percentage": 100.0000, "estimated_amount": 7629, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6103.72, "standard_charge_percentage": 80.0000, "estimated_amount": 6103, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5340.76, "standard_charge_percentage": 70.0000, "estimated_amount": 5340, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5722.24, "standard_charge_percentage": 75.0000, "estimated_amount": 5722, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6866.69, "standard_charge_percentage": 90.0000, "estimated_amount": 6866, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2703.5, "estimated_amount": 2703, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2922.7, "estimated_amount": 2922, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6103.72, "standard_charge_percentage": 80.0000, "estimated_amount": 6103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3814.82, "standard_charge_percentage": 50.0000, "estimated_amount": 3814, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6103.72, "standard_charge_percentage": 80.0000, "estimated_amount": 6103, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7248.17, "standard_charge_percentage": 95.0000, "estimated_amount": 7248, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6103.72, "standard_charge_percentage": 80.0000, "estimated_amount": 6103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5722.24, "standard_charge_percentage": 75.0000, "estimated_amount": 5722, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6256.31, "standard_charge_percentage": 82.0000, "estimated_amount": 6256, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4272.6, "standard_charge_percentage": 56.0000, "estimated_amount": 4272, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6103.72, "standard_charge_percentage": 80.0000, "estimated_amount": 6103, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6866.69, "standard_charge_percentage": 90.0000, "estimated_amount": 6866, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5722.24, "standard_charge_percentage": 75.0000, "estimated_amount": 5722, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5722.24, "standard_charge_percentage": 75.0000, "estimated_amount": 5722, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6866.69, "standard_charge_percentage": 90.0000, "estimated_amount": 6866, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6866.69, "standard_charge_percentage": 90.0000, "estimated_amount": 6866, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6485.2, "standard_charge_percentage": 85.0000, "estimated_amount": 6485, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3051.86, "standard_charge_percentage": 40.0000, "estimated_amount": 3051, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6675.94, "standard_charge_percentage": 87.5000, "estimated_amount": 6675, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6103.72, "standard_charge_percentage": 80.0000, "estimated_amount": 6103, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7629.65, "standard_charge_percentage": 100.0000, "estimated_amount": 7629, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6103.72, "standard_charge_percentage": 80.0000, "estimated_amount": 6103, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5340.76, "standard_charge_percentage": 70.0000, "estimated_amount": 5340, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5340.76, "standard_charge_percentage": 70.0000, "estimated_amount": 5340, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5174.45, "estimated_amount": 5174, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 382.2, "estimated_amount": 382, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6866.69, "standard_charge_percentage": 90.0000, "estimated_amount": 6866, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6675.94, "standard_charge_percentage": 87.5000, "estimated_amount": 6675, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4577.79, "standard_charge_percentage": 60.0000, "estimated_amount": 4577, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6103.72, "standard_charge_percentage": 80.0000, "estimated_amount": 6103, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2288.89, "standard_charge_percentage": 30.0000, "estimated_amount": 2288, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4425.2, "standard_charge_percentage": 58.0000, "estimated_amount": 4425, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2822.97, "standard_charge_percentage": 37.0000, "estimated_amount": 2822, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7477.06, "standard_charge_percentage": 98.0000, "estimated_amount": 7477, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4577.79, "standard_charge_percentage": 60.0000, "estimated_amount": 4577, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1490.58, "estimated_amount": 1490, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1972.82, "estimated_amount": 1972, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" }]}]} , { "description": "Hc Inj W Fluor Eval Cv Device", "code_information": [ { "code": "36598", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 682.67, "discounted_cash": 257,"minimum": 148.4,"maximum": 682.67,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 256.84, "estimated_amount": 256, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 546.14, "standard_charge_percentage": 80.0000, "estimated_amount": 546, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 614.4, "standard_charge_percentage": 90.0000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 273.07, "standard_charge_percentage": 40.0000, "estimated_amount": 273, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 597.34, "standard_charge_percentage": 87.5000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 546.14, "standard_charge_percentage": 80.0000, "estimated_amount": 546, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 546.14, "standard_charge_percentage": 80.0000, "estimated_amount": 546, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 409.6, "standard_charge_percentage": 60.0000, "estimated_amount": 409, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 546.14, "standard_charge_percentage": 80.0000, "estimated_amount": 546, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 546.14, "standard_charge_percentage": 80.0000, "estimated_amount": 546, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 477.87, "standard_charge_percentage": 70.0000, "estimated_amount": 477, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 252.59, "standard_charge_percentage": 37.0000, "estimated_amount": 252, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 409.6, "standard_charge_percentage": 60.0000, "estimated_amount": 409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 198.2, "estimated_amount": 198, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 682.67, "estimated_amount": 682, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 317.12, "estimated_amount": 317, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 179.61, "estimated_amount": 179, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 207.11, "estimated_amount": 207, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 682.67, "estimated_amount": 682, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 341.33, "standard_charge_percentage": 50.0000, "estimated_amount": 341, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 597.34, "standard_charge_percentage": 87.5000, "estimated_amount": 597, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 546.14, "standard_charge_percentage": 80.0000, "estimated_amount": 546, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 512, "standard_charge_percentage": 75.0000, "estimated_amount": 512, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 477.87, "standard_charge_percentage": 70.0000, "estimated_amount": 477, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 614.4, "standard_charge_percentage": 90.0000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 669.02, "standard_charge_percentage": 98.0000, "estimated_amount": 669, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 512, "standard_charge_percentage": 75.0000, "estimated_amount": 512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 198.2, "estimated_amount": 198, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 198.2, "estimated_amount": 198, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 198.2, "estimated_amount": 198, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 260.43, "estimated_amount": 260, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 512, "standard_charge_percentage": 75.0000, "estimated_amount": 512, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 546.14, "standard_charge_percentage": 80.0000, "estimated_amount": 546, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 614.4, "standard_charge_percentage": 90.0000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 614.4, "standard_charge_percentage": 90.0000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 546.14, "standard_charge_percentage": 80.0000, "estimated_amount": 546, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 682.67, "standard_charge_percentage": 100.0000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 546.14, "standard_charge_percentage": 80.0000, "estimated_amount": 546, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 512, "standard_charge_percentage": 75.0000, "estimated_amount": 512, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 559.79, "standard_charge_percentage": 82.0000, "estimated_amount": 559, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 382.3, "standard_charge_percentage": 56.0000, "estimated_amount": 382, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 546.14, "standard_charge_percentage": 80.0000, "estimated_amount": 546, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 614.4, "standard_charge_percentage": 90.0000, "estimated_amount": 614, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 208.11, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 277.48, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 366.67, "estimated_amount": 366, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 198.2, "estimated_amount": 198, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 396.4, "estimated_amount": 396, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 258.64, "estimated_amount": 258, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 148.4, "estimated_amount": 148, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 179.61, "estimated_amount": 179, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 512, "standard_charge_percentage": 75.0000, "estimated_amount": 512, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 580.27, "standard_charge_percentage": 85.0000, "estimated_amount": 580, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 682.67, "standard_charge_percentage": 100.0000, "estimated_amount": 682, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 648.54, "standard_charge_percentage": 95.0000, "estimated_amount": 648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 204.8, "standard_charge_percentage": 30.0000, "estimated_amount": 204, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 477.87, "standard_charge_percentage": 70.0000, "estimated_amount": 477, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 395.95, "standard_charge_percentage": 58.0000, "estimated_amount": 395, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 198.2, "estimated_amount": 198, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 198.2, "estimated_amount": 198, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 277.48, "estimated_amount": 277, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 198.2, "estimated_amount": 198, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 202.16, "estimated_amount": 202, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 267.57, "estimated_amount": 267, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 317.12, "estimated_amount": 317, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 208.11, "estimated_amount": 208, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 198.2, "estimated_amount": 198, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 198.2, "estimated_amount": 198, "methodology": "fee schedule" }]}]} , { "description": "ARTERIAL PUNCTURE", "code_information": [ { "code": "36600", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 332.74, "discounted_cash": 157,"minimum": 41.38,"maximum": 332.74,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 41.38, "estimated_amount": 41, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 157.14, "estimated_amount": 157, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 299.47, "standard_charge_percentage": 90.0000, "estimated_amount": 299, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 299.47, "standard_charge_percentage": 90.0000, "estimated_amount": 299, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 282.83, "standard_charge_percentage": 85.0000, "estimated_amount": 282, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 291.15, "standard_charge_percentage": 87.5000, "estimated_amount": 291, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 266.19, "standard_charge_percentage": 80.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 332.74, "standard_charge_percentage": 100.0000, "estimated_amount": 332, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 266.19, "standard_charge_percentage": 80.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 232.92, "standard_charge_percentage": 70.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 232.92, "standard_charge_percentage": 70.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 332.74, "estimated_amount": 332, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 123.67, "estimated_amount": 123, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 242.5, "estimated_amount": 242, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 266.19, "standard_charge_percentage": 80.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 249.56, "standard_charge_percentage": 75.0000, "estimated_amount": 249, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 133.1, "standard_charge_percentage": 40.0000, "estimated_amount": 133, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 316.1, "standard_charge_percentage": 95.0000, "estimated_amount": 316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 99.82, "standard_charge_percentage": 30.0000, "estimated_amount": 99, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 249.56, "standard_charge_percentage": 75.0000, "estimated_amount": 249, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 299.47, "standard_charge_percentage": 90.0000, "estimated_amount": 299, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 299.47, "standard_charge_percentage": 90.0000, "estimated_amount": 299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 166.37, "standard_charge_percentage": 50.0000, "estimated_amount": 166, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 224.31, "estimated_amount": 224, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 158.24, "estimated_amount": 158, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 159.34, "estimated_amount": 159, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 266.19, "standard_charge_percentage": 80.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 299.47, "standard_charge_percentage": 90.0000, "estimated_amount": 299, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 291.15, "standard_charge_percentage": 87.5000, "estimated_amount": 291, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 266.19, "standard_charge_percentage": 80.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 266.19, "standard_charge_percentage": 80.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 266.19, "standard_charge_percentage": 80.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 249.56, "standard_charge_percentage": 75.0000, "estimated_amount": 249, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 232.92, "standard_charge_percentage": 70.0000, "estimated_amount": 232, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 272.85, "standard_charge_percentage": 82.0000, "estimated_amount": 272, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 186.33, "standard_charge_percentage": 56.0000, "estimated_amount": 186, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 326.09, "standard_charge_percentage": 98.0000, "estimated_amount": 326, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 249.56, "standard_charge_percentage": 75.0000, "estimated_amount": 249, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 199.64, "standard_charge_percentage": 60.0000, "estimated_amount": 199, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 169.75, "estimated_amount": 169, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 127.31, "estimated_amount": 127, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 116.42, "estimated_amount": 116, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 109.89, "estimated_amount": 109, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 249.56, "standard_charge_percentage": 75.0000, "estimated_amount": 249, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 166.37, "standard_charge_percentage": 50.0000, "estimated_amount": 166, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 266.19, "standard_charge_percentage": 80.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 332.74, "standard_charge_percentage": 100.0000, "estimated_amount": 332, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 199.64, "standard_charge_percentage": 60.0000, "estimated_amount": 199, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 266.19, "standard_charge_percentage": 80.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 192.99, "standard_charge_percentage": 58.0000, "estimated_amount": 192, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 123.11, "standard_charge_percentage": 37.0000, "estimated_amount": 123, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 266.19, "standard_charge_percentage": 80.0000, "estimated_amount": 266, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 163.69, "estimated_amount": 163, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 194, "estimated_amount": 194, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 121.25, "estimated_amount": 121, "methodology": "fee schedule" }]}]} , { "description": "Hc Arterial Line Insertion", "code_information": [ { "code": "36620", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1443.93,"minimum": 234,"maximum": 1443.93,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1299.54, "standard_charge_percentage": 90.0000, "estimated_amount": 1299, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1263.44, "standard_charge_percentage": 87.5000, "estimated_amount": 1263, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1155.14, "standard_charge_percentage": 80.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1010.75, "standard_charge_percentage": 70.0000, "estimated_amount": 1010, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1010.75, "standard_charge_percentage": 70.0000, "estimated_amount": 1010, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1184.02, "standard_charge_percentage": 82.0000, "estimated_amount": 1184, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1155.14, "standard_charge_percentage": 80.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1299.54, "standard_charge_percentage": 90.0000, "estimated_amount": 1299, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1082.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1082, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1155.14, "standard_charge_percentage": 80.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 577.57, "standard_charge_percentage": 40.0000, "estimated_amount": 577, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1155.14, "standard_charge_percentage": 80.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1443.93, "standard_charge_percentage": 100.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1155.14, "standard_charge_percentage": 80.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1155.14, "standard_charge_percentage": 80.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 433.18, "standard_charge_percentage": 30.0000, "estimated_amount": 433, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 837.48, "standard_charge_percentage": 58.0000, "estimated_amount": 837, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 534.25, "standard_charge_percentage": 37.0000, "estimated_amount": 534, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1299.54, "standard_charge_percentage": 90.0000, "estimated_amount": 1299, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1443.93, "estimated_amount": 1443, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1299.54, "standard_charge_percentage": 90.0000, "estimated_amount": 1299, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1299.54, "standard_charge_percentage": 90.0000, "estimated_amount": 1299, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1155.14, "standard_charge_percentage": 80.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1155.14, "standard_charge_percentage": 80.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1443.93, "standard_charge_percentage": 100.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 866.36, "standard_charge_percentage": 60.0000, "estimated_amount": 866, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1082.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1082, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1082.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1082, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 866.36, "standard_charge_percentage": 60.0000, "estimated_amount": 866, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 234, "estimated_amount": 234, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1082.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1082, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1155.14, "standard_charge_percentage": 80.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 721.97, "standard_charge_percentage": 50.0000, "estimated_amount": 721, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1227.34, "standard_charge_percentage": 85.0000, "estimated_amount": 1227, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1263.44, "standard_charge_percentage": 87.5000, "estimated_amount": 1263, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1371.73, "standard_charge_percentage": 95.0000, "estimated_amount": 1371, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1155.14, "standard_charge_percentage": 80.0000, "estimated_amount": 1155, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1010.75, "standard_charge_percentage": 70.0000, "estimated_amount": 1010, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 808.6, "standard_charge_percentage": 56.0000, "estimated_amount": 808, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1415.05, "standard_charge_percentage": 98.0000, "estimated_amount": 1415, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1082.95, "standard_charge_percentage": 75.0000, "estimated_amount": 1082, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Insert Needle,Intraosseous Infusn", "code_information": [ { "code": "36680", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1604.02, "discounted_cash": 487,"minimum": 340.17,"maximum": 1604.02,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 378.54, "estimated_amount": 378, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1283.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1283.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1443.62, "standard_charge_percentage": 90.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1403.52, "standard_charge_percentage": 87.5000, "estimated_amount": 1403, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1403.52, "standard_charge_percentage": 87.5000, "estimated_amount": 1403, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1283.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 962.41, "standard_charge_percentage": 60.0000, "estimated_amount": 962, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1203.02, "standard_charge_percentage": 75.0000, "estimated_amount": 1203, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 593.49, "standard_charge_percentage": 37.0000, "estimated_amount": 593, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1443.62, "standard_charge_percentage": 90.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1571.94, "standard_charge_percentage": 98.0000, "estimated_amount": 1571, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 394.15, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 525.53, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1604.02, "estimated_amount": 1604, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1203.02, "standard_charge_percentage": 75.0000, "estimated_amount": 1203, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1443.62, "standard_charge_percentage": 90.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1363.42, "standard_charge_percentage": 85.0000, "estimated_amount": 1363, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 641.61, "standard_charge_percentage": 40.0000, "estimated_amount": 641, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1283.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1283.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1122.81, "standard_charge_percentage": 70.0000, "estimated_amount": 1122, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1203.02, "standard_charge_percentage": 75.0000, "estimated_amount": 1203, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 930.33, "standard_charge_percentage": 58.0000, "estimated_amount": 930, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1283.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1203.02, "standard_charge_percentage": 75.0000, "estimated_amount": 1203, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 962.41, "standard_charge_percentage": 60.0000, "estimated_amount": 962, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 525.53, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 382.89, "estimated_amount": 382, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 750.76, "estimated_amount": 750, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 489.84, "estimated_amount": 489, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 493.25, "estimated_amount": 493, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 486.44, "estimated_amount": 486, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1203.02, "standard_charge_percentage": 75.0000, "estimated_amount": 1203, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1443.62, "standard_charge_percentage": 90.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1283.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1283.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1283.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 481.21, "standard_charge_percentage": 30.0000, "estimated_amount": 481, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1122.81, "standard_charge_percentage": 70.0000, "estimated_amount": 1122, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 898.25, "standard_charge_percentage": 56.0000, "estimated_amount": 898, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1443.62, "standard_charge_percentage": 90.0000, "estimated_amount": 1443, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1329.17, "estimated_amount": 1329, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 506.76, "estimated_amount": 506, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 394.15, "estimated_amount": 394, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 600.61, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 340.17, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 340.17, "estimated_amount": 340, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 802.01, "standard_charge_percentage": 50.0000, "estimated_amount": 802, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1283.22, "standard_charge_percentage": 80.0000, "estimated_amount": 1283, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1604.02, "standard_charge_percentage": 100.0000, "estimated_amount": 1604, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1523.82, "standard_charge_percentage": 95.0000, "estimated_amount": 1523, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1604.02, "standard_charge_percentage": 100.0000, "estimated_amount": 1604, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1122.81, "standard_charge_percentage": 70.0000, "estimated_amount": 1122, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1315.3, "standard_charge_percentage": 82.0000, "estimated_amount": 1315, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 600.61, "estimated_amount": 600, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 375.38, "estimated_amount": 375, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 694.45, "estimated_amount": 694, "methodology": "fee schedule" }]}]} , { "description": "Hc Intro Cath Dialysis Circ Dx Angrph Fluor S&I", "code_information": [ { "code": "36901", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3990.53, "discounted_cash": 1899,"minimum": 462.47,"maximum": 3990.53,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 462.47, "estimated_amount": 462, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 518.82, "estimated_amount": 518, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 1920.21, "estimated_amount": 1920, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1893.72, "estimated_amount": 1893, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3391.95, "standard_charge_percentage": 85.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3272.23, "standard_charge_percentage": 82.0000, "estimated_amount": 3272, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1476.5, "standard_charge_percentage": 37.0000, "estimated_amount": 1476, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2703.5, "estimated_amount": 2703, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 2922.7, "estimated_amount": 2922, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3491.71, "standard_charge_percentage": 87.5000, "estimated_amount": 3491, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3990.53, "standard_charge_percentage": 100.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3791, "standard_charge_percentage": 95.0000, "estimated_amount": 3791, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2314.51, "standard_charge_percentage": 58.0000, "estimated_amount": 2314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1906.96, "estimated_amount": 1906, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3990.53, "standard_charge_percentage": 100.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2394.32, "standard_charge_percentage": 60.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2234.7, "standard_charge_percentage": 56.0000, "estimated_amount": 2234, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3910.72, "standard_charge_percentage": 98.0000, "estimated_amount": 3910, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2045.89, "estimated_amount": 2045, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1490.58, "estimated_amount": 1490, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 1972.82, "estimated_amount": 1972, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1534.42, "estimated_amount": 1534, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1324.28, "estimated_amount": 1324, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1491.71, "estimated_amount": 1491, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1995.27, "standard_charge_percentage": 50.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1596.21, "standard_charge_percentage": 40.0000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3491.71, "standard_charge_percentage": 87.5000, "estimated_amount": 3491, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1197.16, "standard_charge_percentage": 30.0000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2394.32, "standard_charge_percentage": 60.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1461.35, "estimated_amount": 1461, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2338.16, "estimated_amount": 2338, "methodology": "fee schedule" }]}]} , { "description": "Hc Intro Cath Dialysis Circ W/Trluml Balo Angiop S&I", "code_information": [ { "code": "36902", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18554, "discounted_cash": 6972,"minimum": 3261.84,"maximum": 18554,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 6999.03, "estimated_amount": 6999, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 3261.84, "estimated_amount": 3261, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 5228.96, "estimated_amount": 5228, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 4860.44, "estimated_amount": 4860, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 7047.64, "estimated_amount": 7047, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 6950.43, "estimated_amount": 6950, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9277, "standard_charge_percentage": 50.0000, "estimated_amount": 9277, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 15770.9, "standard_charge_percentage": 85.0000, "estimated_amount": 15770, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 17626.3, "standard_charge_percentage": 95.0000, "estimated_amount": 17626, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5566.2, "standard_charge_percentage": 30.0000, "estimated_amount": 5566, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 6864.98, "standard_charge_percentage": 37.0000, "estimated_amount": 6864, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 11132.4, "standard_charge_percentage": 60.0000, "estimated_amount": 11132, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 7508.94, "estimated_amount": 7508, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 5470.8, "estimated_amount": 5470, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 8581.65, "estimated_amount": 8581, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 4860.44, "estimated_amount": 4860, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 18182.9, "standard_charge_percentage": 98.0000, "estimated_amount": 18182, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 7240.77, "estimated_amount": 7240, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 10727.1, "estimated_amount": 10727, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 3588.02, "estimated_amount": 3588, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5151, "estimated_amount": 5151, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 16234.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 18554, "standard_charge_percentage": 100.0000, "estimated_amount": 18554, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 10761.3, "standard_charge_percentage": 58.0000, "estimated_amount": 10761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7421.6, "standard_charge_percentage": 40.0000, "estimated_amount": 7421, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 16234.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 18554, "standard_charge_percentage": 100.0000, "estimated_amount": 18554, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 11132.4, "standard_charge_percentage": 60.0000, "estimated_amount": 11132, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 15214.3, "standard_charge_percentage": 82.0000, "estimated_amount": 15214, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10390.2, "standard_charge_percentage": 56.0000, "estimated_amount": 10390, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 5631.71, "estimated_amount": 5631, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 5631.71, "estimated_amount": 5631, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 7508.94, "estimated_amount": 7508, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9922.53, "estimated_amount": 9922, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 8581.65, "estimated_amount": 8581, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Thrmbc/Nfs Dialysis Circ Img Dx Angrph S&I", "code_information": [ { "code": "36904", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 28046.1, "discounted_cash": 6972,"minimum": 3261.84,"maximum": 28046.1,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 3588.02, "estimated_amount": 3588, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 4860.44, "estimated_amount": 4860, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4489, "estimated_amount": 4489, "methodology": "case rate" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 26643.8, "standard_charge_percentage": 95.0000, "estimated_amount": 26643, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 28046.1, "standard_charge_percentage": 100.0000, "estimated_amount": 28046, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 16827.7, "standard_charge_percentage": 60.0000, "estimated_amount": 16827, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 22436.9, "standard_charge_percentage": 80.0000, "estimated_amount": 22436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 21034.6, "standard_charge_percentage": 75.0000, "estimated_amount": 21034, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 19632.3, "standard_charge_percentage": 70.0000, "estimated_amount": 19632, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 19632.3, "standard_charge_percentage": 70.0000, "estimated_amount": 19632, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 22997.8, "standard_charge_percentage": 82.0000, "estimated_amount": 22997, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 10377.1, "standard_charge_percentage": 37.0000, "estimated_amount": 10377, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 21034.6, "standard_charge_percentage": 75.0000, "estimated_amount": 21034, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 5631.71, "estimated_amount": 5631, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 7508.94, "estimated_amount": 7508, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 8581.65, "estimated_amount": 8581, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 4860.44, "estimated_amount": 4860, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 22436.9, "standard_charge_percentage": 80.0000, "estimated_amount": 22436, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 25241.5, "standard_charge_percentage": 90.0000, "estimated_amount": 25241, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 25241.5, "standard_charge_percentage": 90.0000, "estimated_amount": 25241, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 22436.9, "standard_charge_percentage": 80.0000, "estimated_amount": 22436, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 28046.1, "standard_charge_percentage": 100.0000, "estimated_amount": 28046, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 22436.9, "standard_charge_percentage": 80.0000, "estimated_amount": 22436, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 8413.83, "standard_charge_percentage": 30.0000, "estimated_amount": 8413, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 21034.6, "standard_charge_percentage": 75.0000, "estimated_amount": 21034, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 22436.9, "standard_charge_percentage": 80.0000, "estimated_amount": 22436, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 25241.5, "standard_charge_percentage": 90.0000, "estimated_amount": 25241, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 25241.5, "standard_charge_percentage": 90.0000, "estimated_amount": 25241, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 7240.77, "estimated_amount": 7240, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 10727.1, "estimated_amount": 10727, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 14023, "standard_charge_percentage": 50.0000, "estimated_amount": 14023, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 25241.5, "standard_charge_percentage": 90.0000, "estimated_amount": 25241, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 11218.4, "standard_charge_percentage": 40.0000, "estimated_amount": 11218, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 24540.3, "standard_charge_percentage": 87.5000, "estimated_amount": 24540, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 22436.9, "standard_charge_percentage": 80.0000, "estimated_amount": 22436, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 22436.9, "standard_charge_percentage": 80.0000, "estimated_amount": 22436, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 22436.9, "standard_charge_percentage": 80.0000, "estimated_amount": 22436, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 19632.3, "standard_charge_percentage": 70.0000, "estimated_amount": 19632, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 15705.8, "standard_charge_percentage": 56.0000, "estimated_amount": 15705, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 16266.7, "standard_charge_percentage": 58.0000, "estimated_amount": 16266, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 16827.7, "standard_charge_percentage": 60.0000, "estimated_amount": 16827, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 5470.8, "estimated_amount": 5470, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 8581.65, "estimated_amount": 8581, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 5631.71, "estimated_amount": 5631, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9922.53, "estimated_amount": 9922, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 6999.03, "estimated_amount": 6999, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 3261.84, "estimated_amount": 3261, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 5228.96, "estimated_amount": 5228, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 7047.64, "estimated_amount": 7047, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 6950.43, "estimated_amount": 6950, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 21034.6, "standard_charge_percentage": 75.0000, "estimated_amount": 21034, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 22436.9, "standard_charge_percentage": 80.0000, "estimated_amount": 22436, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 21034.6, "standard_charge_percentage": 75.0000, "estimated_amount": 21034, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 23839.2, "standard_charge_percentage": 85.0000, "estimated_amount": 23839, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 24540.3, "standard_charge_percentage": 87.5000, "estimated_amount": 24540, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 22436.9, "standard_charge_percentage": 80.0000, "estimated_amount": 22436, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 27485.2, "standard_charge_percentage": 98.0000, "estimated_amount": 27485, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 7508.94, "estimated_amount": 7508, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 18991.5, "estimated_amount": 18991, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Thrmbc/Nfs Dial Circ Trluml Balo Angiop S&I", "code_information": [ { "code": "36905", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 38348.3, "discounted_cash": 13868,"minimum": 5151,"maximum": 38348.3,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 6592.64, "estimated_amount": 6592, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 14018, "estimated_amount": 14018, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 13824.7, "estimated_amount": 13824, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 32596.1, "standard_charge_percentage": 85.0000, "estimated_amount": 32596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 33554.8, "standard_charge_percentage": 87.5000, "estimated_amount": 33554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 22242, "standard_charge_percentage": 58.0000, "estimated_amount": 22242, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 14188.9, "standard_charge_percentage": 37.0000, "estimated_amount": 14188, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 37581.3, "standard_charge_percentage": 98.0000, "estimated_amount": 37581, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 7251.9, "estimated_amount": 7251, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 31445.6, "standard_charge_percentage": 82.0000, "estimated_amount": 31445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 23009, "standard_charge_percentage": 60.0000, "estimated_amount": 23008, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 14402.2, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5151, "estimated_amount": 5151, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 19174.2, "standard_charge_percentage": 50.0000, "estimated_amount": 19174, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11504.5, "standard_charge_percentage": 30.0000, "estimated_amount": 11504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 21475, "standard_charge_percentage": 56.0000, "estimated_amount": 21475, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10881.7, "estimated_amount": 10881, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 13921.4, "estimated_amount": 13921, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 15339.3, "standard_charge_percentage": 40.0000, "estimated_amount": 15339, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 33554.8, "standard_charge_percentage": 87.5000, "estimated_amount": 33554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 38348.3, "standard_charge_percentage": 100.0000, "estimated_amount": 38348, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 36430.9, "standard_charge_percentage": 95.0000, "estimated_amount": 36430, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 38348.3, "standard_charge_percentage": 100.0000, "estimated_amount": 38348, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 23009, "standard_charge_percentage": 60.0000, "estimated_amount": 23008, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 37775, "estimated_amount": 37775, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 19736.3, "estimated_amount": 19736, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 21336.6, "estimated_amount": 21336, "methodology": "fee schedule" }]}]} , { "description": "Hc Perq Thrmbc/Nfs Dial Circ Tcat Plmt Iv Stent S&I", "code_information": [ { "code": "36906", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 68434.5, "discounted_cash": 21959,"minimum": 5151,"maximum": 68434.5,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 22043.2, "estimated_amount": 22043, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 59880.2, "standard_charge_percentage": 87.5000, "estimated_amount": 59880, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 54747.6, "standard_charge_percentage": 80.0000, "estimated_amount": 54747, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 54747.6, "standard_charge_percentage": 80.0000, "estimated_amount": 54747, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 54747.6, "standard_charge_percentage": 80.0000, "estimated_amount": 54747, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 51325.9, "standard_charge_percentage": 75.0000, "estimated_amount": 51325, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 47904.2, "standard_charge_percentage": 70.0000, "estimated_amount": 47904, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 51325.9, "standard_charge_percentage": 75.0000, "estimated_amount": 51325, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 56116.3, "standard_charge_percentage": 82.0000, "estimated_amount": 56116, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 38323.3, "standard_charge_percentage": 56.0000, "estimated_amount": 38323, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 25320.8, "standard_charge_percentage": 37.0000, "estimated_amount": 25320, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 61591.1, "standard_charge_percentage": 90.0000, "estimated_amount": 61591, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 51325.9, "standard_charge_percentage": 75.0000, "estimated_amount": 51325, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 27027.6, "estimated_amount": 27027, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 23649.1, "estimated_amount": 23649, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 33784.5, "estimated_amount": 33784, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 9992.73, "estimated_amount": 9992, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 34217.3, "standard_charge_percentage": 50.0000, "estimated_amount": 34217, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 61591.1, "standard_charge_percentage": 90.0000, "estimated_amount": 61591, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 59880.2, "standard_charge_percentage": 87.5000, "estimated_amount": 59880, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 68434.5, "standard_charge_percentage": 100.0000, "estimated_amount": 68434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 68434.5, "standard_charge_percentage": 100.0000, "estimated_amount": 68434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 54747.6, "standard_charge_percentage": 80.0000, "estimated_amount": 54747, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 54747.6, "standard_charge_percentage": 80.0000, "estimated_amount": 54747, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 39692, "standard_charge_percentage": 58.0000, "estimated_amount": 39692, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 54747.6, "standard_charge_percentage": 80.0000, "estimated_amount": 54747, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 61591.1, "standard_charge_percentage": 90.0000, "estimated_amount": 61591, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 67065.8, "standard_charge_percentage": 98.0000, "estimated_amount": 67065, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 41060.7, "standard_charge_percentage": 60.0000, "estimated_amount": 41060, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 23649.1, "estimated_amount": 23649, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 27027.6, "estimated_amount": 27027, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 10992, "estimated_amount": 10992, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5151, "estimated_amount": 5151, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 51325.9, "standard_charge_percentage": 75.0000, "estimated_amount": 51325, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 51325.9, "standard_charge_percentage": 75.0000, "estimated_amount": 51325, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 54747.6, "standard_charge_percentage": 80.0000, "estimated_amount": 54747, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 58169.3, "standard_charge_percentage": 85.0000, "estimated_amount": 58169, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 54747.6, "standard_charge_percentage": 80.0000, "estimated_amount": 54747, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 47904.2, "standard_charge_percentage": 70.0000, "estimated_amount": 47904, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 59813.2, "estimated_amount": 59813, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 17222.3, "estimated_amount": 17222, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 22196.3, "estimated_amount": 22196, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 21890.1, "estimated_amount": 21890, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 54747.6, "standard_charge_percentage": 80.0000, "estimated_amount": 54747, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 61591.1, "standard_charge_percentage": 90.0000, "estimated_amount": 61591, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 61591.1, "standard_charge_percentage": 90.0000, "estimated_amount": 61591, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 27373.8, "standard_charge_percentage": 40.0000, "estimated_amount": 27373, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 54747.6, "standard_charge_percentage": 80.0000, "estimated_amount": 54747, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 65012.8, "standard_charge_percentage": 95.0000, "estimated_amount": 65012, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 41060.7, "standard_charge_percentage": 60.0000, "estimated_amount": 41060, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 20530.3, "standard_charge_percentage": 30.0000, "estimated_amount": 20530, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 47904.2, "standard_charge_percentage": 70.0000, "estimated_amount": 47904, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 17230.1, "estimated_amount": 17230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 22804.5, "estimated_amount": 22804, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 31250.6, "estimated_amount": 31250, "methodology": "fee schedule" }]}]} , { "description": "Hc Trluml Balo Angiop Ctr Dialysis Seg W/Img S&I", "code_information": [ { "code": "36907", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5039.22,"minimum": 82.37,"maximum": 5039.22,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3779.41, "standard_charge_percentage": 75.0000, "estimated_amount": 3779, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2519.61, "standard_charge_percentage": 50.0000, "estimated_amount": 2519, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 4535.3, "standard_charge_percentage": 90.0000, "estimated_amount": 4535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 4409.32, "standard_charge_percentage": 87.5000, "estimated_amount": 4409, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4031.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4031.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3779.41, "standard_charge_percentage": 75.0000, "estimated_amount": 3779, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3779.41, "standard_charge_percentage": 75.0000, "estimated_amount": 3779, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2821.96, "standard_charge_percentage": 56.0000, "estimated_amount": 2821, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1864.51, "standard_charge_percentage": 37.0000, "estimated_amount": 1864, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 4535.3, "standard_charge_percentage": 90.0000, "estimated_amount": 4535, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 4938.44, "standard_charge_percentage": 98.0000, "estimated_amount": 4938, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3779.41, "standard_charge_percentage": 75.0000, "estimated_amount": 3779, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4031.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2015.69, "standard_charge_percentage": 40.0000, "estimated_amount": 2015, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4031.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5039.22, "standard_charge_percentage": 100.0000, "estimated_amount": 5039, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4031.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4031.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3527.45, "standard_charge_percentage": 70.0000, "estimated_amount": 3527, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3779.41, "standard_charge_percentage": 75.0000, "estimated_amount": 3779, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3023.53, "standard_charge_percentage": 60.0000, "estimated_amount": 3023, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4031.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 4535.3, "standard_charge_percentage": 90.0000, "estimated_amount": 4535, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4031.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5039.22, "standard_charge_percentage": 100.0000, "estimated_amount": 5039, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 4787.26, "standard_charge_percentage": 95.0000, "estimated_amount": 4787, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3023.53, "standard_charge_percentage": 60.0000, "estimated_amount": 3023, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4031.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1511.77, "standard_charge_percentage": 30.0000, "estimated_amount": 1511, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3527.45, "standard_charge_percentage": 70.0000, "estimated_amount": 3527, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3527.45, "standard_charge_percentage": 70.0000, "estimated_amount": 3527, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4132.16, "standard_charge_percentage": 82.0000, "estimated_amount": 4132, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2922.75, "standard_charge_percentage": 58.0000, "estimated_amount": 2922, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4031.38, "standard_charge_percentage": 80.0000, "estimated_amount": 4031, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 4535.3, "standard_charge_percentage": 90.0000, "estimated_amount": 4535, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 82.37, "estimated_amount": 82, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 4535.3, "standard_charge_percentage": 90.0000, "estimated_amount": 4535, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4283.34, "standard_charge_percentage": 85.0000, "estimated_amount": 4283, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 4409.32, "standard_charge_percentage": 87.5000, "estimated_amount": 4409, "methodology": "percent of total billed charges" }]}]} , { "description": "CONSC SEDATION 5Y OR > 1ST 30M", "code_information": [ { "code": "37000001", "type": "CDM" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 393.38,"minimum": 27.81,"maximum": 393.38,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 295.04, "standard_charge_percentage": 75.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 157.35, "standard_charge_percentage": 40.0000, "estimated_amount": 157, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 220.29, "standard_charge_percentage": 56.0000, "estimated_amount": 220, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 354.04, "standard_charge_percentage": 90.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 354.04, "standard_charge_percentage": 90.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 344.21, "standard_charge_percentage": 87.5000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 344.21, "standard_charge_percentage": 87.5000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 393.38, "standard_charge_percentage": 100.0000, "estimated_amount": 393, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 236.03, "standard_charge_percentage": 60.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 118.01, "standard_charge_percentage": 30.0000, "estimated_amount": 118, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 275.37, "standard_charge_percentage": 70.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 228.16, "standard_charge_percentage": 58.0000, "estimated_amount": 228, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 236.03, "standard_charge_percentage": 60.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 196.69, "standard_charge_percentage": 50.0000, "estimated_amount": 196, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 354.04, "standard_charge_percentage": 90.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 334.37, "standard_charge_percentage": 85.0000, "estimated_amount": 334, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 295.04, "standard_charge_percentage": 75.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 275.37, "standard_charge_percentage": 70.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 275.37, "standard_charge_percentage": 70.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 295.04, "standard_charge_percentage": 75.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 322.57, "standard_charge_percentage": 82.0000, "estimated_amount": 322, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 145.55, "standard_charge_percentage": 37.0000, "estimated_amount": 145, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 295.04, "standard_charge_percentage": 75.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 196.69, "standard_charge_percentage": 50.0000, "estimated_amount": 196, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 295.04, "standard_charge_percentage": 75.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 373.71, "standard_charge_percentage": 95.0000, "estimated_amount": 373, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 393.38, "standard_charge_percentage": 100.0000, "estimated_amount": 393, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 354.04, "standard_charge_percentage": 90.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 354.04, "standard_charge_percentage": 90.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 385.51, "standard_charge_percentage": 98.0000, "estimated_amount": 385, "methodology": "percent of total billed charges" }]}]} , { "description": "N BLOCK ING FERN,CONT INF", "code_information": [ { "code": "37000002", "type": "CDM" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 98.34,"minimum": 27.81,"maximum": 393.38,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 88.51, "standard_charge_percentage": 90.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 88.51, "standard_charge_percentage": 90.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 83.59, "standard_charge_percentage": 85.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 68.84, "standard_charge_percentage": 70.0000, "estimated_amount": 68, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 96.37, "standard_charge_percentage": 98.0000, "estimated_amount": 96, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 86.05, "standard_charge_percentage": 87.5000, "estimated_amount": 86, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 98.34, "standard_charge_percentage": 100.0000, "estimated_amount": 98, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 73.75, "standard_charge_percentage": 75.0000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 68.84, "standard_charge_percentage": 70.0000, "estimated_amount": 68, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 55.07, "standard_charge_percentage": 56.0000, "estimated_amount": 55, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 73.75, "standard_charge_percentage": 75.0000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 59, "standard_charge_percentage": 60.0000, "estimated_amount": 59, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 49.17, "standard_charge_percentage": 50.0000, "estimated_amount": 49, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 73.75, "standard_charge_percentage": 75.0000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 49.17, "standard_charge_percentage": 50.0000, "estimated_amount": 49, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 39.34, "standard_charge_percentage": 40.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 86.05, "standard_charge_percentage": 87.5000, "estimated_amount": 86, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 59, "standard_charge_percentage": 60.0000, "estimated_amount": 59, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 29.5, "standard_charge_percentage": 30.0000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 73.75, "standard_charge_percentage": 75.0000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 80.64, "standard_charge_percentage": 82.0000, "estimated_amount": 80, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 57.04, "standard_charge_percentage": 58.0000, "estimated_amount": 57, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 36.39, "standard_charge_percentage": 37.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 88.51, "standard_charge_percentage": 90.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 73.75, "standard_charge_percentage": 75.0000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 88.51, "standard_charge_percentage": 90.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 98.34, "standard_charge_percentage": 100.0000, "estimated_amount": 98, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 93.42, "standard_charge_percentage": 95.0000, "estimated_amount": 93, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 68.84, "standard_charge_percentage": 70.0000, "estimated_amount": 68, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 88.51, "standard_charge_percentage": 90.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Block/Spinal 1St 60 Min", "code_information": [ { "code": "37000003", "type": "CDM" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 370.8,"minimum": 27.81,"maximum": 393.38,"payers_information":[{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 296.64, "standard_charge_percentage": 80.0000, "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 315.18, "standard_charge_percentage": 85.0000, "estimated_amount": 315, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 296.64, "standard_charge_percentage": 80.0000, "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 296.64, "standard_charge_percentage": 80.0000, "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 259.56, "standard_charge_percentage": 70.0000, "estimated_amount": 259, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 304.06, "standard_charge_percentage": 82.0000, "estimated_amount": 304, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 333.72, "standard_charge_percentage": 90.0000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 185.4, "standard_charge_percentage": 50.0000, "estimated_amount": 185, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 296.64, "standard_charge_percentage": 80.0000, "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 278.1, "standard_charge_percentage": 75.0000, "estimated_amount": 278, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 333.72, "standard_charge_percentage": 90.0000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 333.72, "standard_charge_percentage": 90.0000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 296.64, "standard_charge_percentage": 80.0000, "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 370.8, "standard_charge_percentage": 100.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 370.8, "standard_charge_percentage": 100.0000, "estimated_amount": 370, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 222.48, "standard_charge_percentage": 60.0000, "estimated_amount": 222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 296.64, "standard_charge_percentage": 80.0000, "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 296.64, "standard_charge_percentage": 80.0000, "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 278.1, "standard_charge_percentage": 75.0000, "estimated_amount": 278, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 296.64, "standard_charge_percentage": 80.0000, "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 333.72, "standard_charge_percentage": 90.0000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 363.38, "standard_charge_percentage": 98.0000, "estimated_amount": 363, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 278.1, "standard_charge_percentage": 75.0000, "estimated_amount": 278, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 278.1, "standard_charge_percentage": 75.0000, "estimated_amount": 278, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 333.72, "standard_charge_percentage": 90.0000, "estimated_amount": 333, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 352.26, "standard_charge_percentage": 95.0000, "estimated_amount": 352, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 296.64, "standard_charge_percentage": 80.0000, "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 296.64, "standard_charge_percentage": 80.0000, "estimated_amount": 296, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 259.56, "standard_charge_percentage": 70.0000, "estimated_amount": 259, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 207.65, "standard_charge_percentage": 56.0000, "estimated_amount": 207, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 215.06, "standard_charge_percentage": 58.0000, "estimated_amount": 215, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 185.4, "standard_charge_percentage": 50.0000, "estimated_amount": 185, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 148.32, "standard_charge_percentage": 40.0000, "estimated_amount": 148, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 324.45, "standard_charge_percentage": 87.5000, "estimated_amount": 324, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 324.45, "standard_charge_percentage": 87.5000, "estimated_amount": 324, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 111.24, "standard_charge_percentage": 30.0000, "estimated_amount": 111, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 259.56, "standard_charge_percentage": 70.0000, "estimated_amount": 259, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 278.1, "standard_charge_percentage": 75.0000, "estimated_amount": 278, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 137.2, "standard_charge_percentage": 37.0000, "estimated_amount": 137, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 222.48, "standard_charge_percentage": 60.0000, "estimated_amount": 222, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Block/Spinal Addl 15 Min", "code_information": [ { "code": "37000004", "type": "CDM" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 92.7,"minimum": 27.81,"maximum": 393.38,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 74.16, "standard_charge_percentage": 80.0000, "estimated_amount": 74, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 83.43, "standard_charge_percentage": 90.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 78.8, "standard_charge_percentage": 85.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 37.08, "standard_charge_percentage": 40.0000, "estimated_amount": 37, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 81.11, "standard_charge_percentage": 87.5000, "estimated_amount": 81, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 74.16, "standard_charge_percentage": 80.0000, "estimated_amount": 74, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 74.16, "standard_charge_percentage": 80.0000, "estimated_amount": 74, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 74.16, "standard_charge_percentage": 80.0000, "estimated_amount": 74, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 83.43, "standard_charge_percentage": 90.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 69.53, "standard_charge_percentage": 75.0000, "estimated_amount": 69, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 46.35, "standard_charge_percentage": 50.0000, "estimated_amount": 46, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 74.16, "standard_charge_percentage": 80.0000, "estimated_amount": 74, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 92.7, "standard_charge_percentage": 100.0000, "estimated_amount": 92, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 88.06, "standard_charge_percentage": 95.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 64.89, "standard_charge_percentage": 70.0000, "estimated_amount": 64, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 64.89, "standard_charge_percentage": 70.0000, "estimated_amount": 64, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 76.01, "standard_charge_percentage": 82.0000, "estimated_amount": 76, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 55.62, "standard_charge_percentage": 60.0000, "estimated_amount": 55, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 69.53, "standard_charge_percentage": 75.0000, "estimated_amount": 69, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 83.43, "standard_charge_percentage": 90.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 83.43, "standard_charge_percentage": 90.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 81.11, "standard_charge_percentage": 87.5000, "estimated_amount": 81, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 92.7, "standard_charge_percentage": 100.0000, "estimated_amount": 92, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 27.81, "standard_charge_percentage": 30.0000, "estimated_amount": 27, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 69.53, "standard_charge_percentage": 75.0000, "estimated_amount": 69, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 69.53, "standard_charge_percentage": 75.0000, "estimated_amount": 69, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 83.43, "standard_charge_percentage": 90.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 69.53, "standard_charge_percentage": 75.0000, "estimated_amount": 69, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 74.16, "standard_charge_percentage": 80.0000, "estimated_amount": 74, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 74.16, "standard_charge_percentage": 80.0000, "estimated_amount": 74, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 55.62, "standard_charge_percentage": 60.0000, "estimated_amount": 55, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 74.16, "standard_charge_percentage": 80.0000, "estimated_amount": 74, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 74.16, "standard_charge_percentage": 80.0000, "estimated_amount": 74, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 64.89, "standard_charge_percentage": 70.0000, "estimated_amount": 64, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 51.91, "standard_charge_percentage": 56.0000, "estimated_amount": 51, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 53.77, "standard_charge_percentage": 58.0000, "estimated_amount": 53, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 34.3, "standard_charge_percentage": 37.0000, "estimated_amount": 34, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 74.16, "standard_charge_percentage": 80.0000, "estimated_amount": 74, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 90.85, "standard_charge_percentage": 98.0000, "estimated_amount": 90, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 46.35, "standard_charge_percentage": 50.0000, "estimated_amount": 46, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Mac 1St 60 Min", "code_information": [ { "code": "37000005", "type": "CDM" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 393.38,"minimum": 27.81,"maximum": 393.38,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 354.04, "standard_charge_percentage": 90.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 354.04, "standard_charge_percentage": 90.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 344.21, "standard_charge_percentage": 87.5000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 344.21, "standard_charge_percentage": 87.5000, "estimated_amount": 344, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 236.03, "standard_charge_percentage": 60.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 118.01, "standard_charge_percentage": 30.0000, "estimated_amount": 118, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 275.37, "standard_charge_percentage": 70.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 228.16, "standard_charge_percentage": 58.0000, "estimated_amount": 228, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 295.04, "standard_charge_percentage": 75.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 157.35, "standard_charge_percentage": 40.0000, "estimated_amount": 157, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 220.29, "standard_charge_percentage": 56.0000, "estimated_amount": 220, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 295.04, "standard_charge_percentage": 75.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 393.38, "standard_charge_percentage": 100.0000, "estimated_amount": 393, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 373.71, "standard_charge_percentage": 95.0000, "estimated_amount": 373, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 393.38, "standard_charge_percentage": 100.0000, "estimated_amount": 393, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 354.04, "standard_charge_percentage": 90.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 354.04, "standard_charge_percentage": 90.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 385.51, "standard_charge_percentage": 98.0000, "estimated_amount": 385, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 236.03, "standard_charge_percentage": 60.0000, "estimated_amount": 236, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 196.69, "standard_charge_percentage": 50.0000, "estimated_amount": 196, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 354.04, "standard_charge_percentage": 90.0000, "estimated_amount": 354, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 334.37, "standard_charge_percentage": 85.0000, "estimated_amount": 334, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 295.04, "standard_charge_percentage": 75.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 275.37, "standard_charge_percentage": 70.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 275.37, "standard_charge_percentage": 70.0000, "estimated_amount": 275, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 295.04, "standard_charge_percentage": 75.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 322.57, "standard_charge_percentage": 82.0000, "estimated_amount": 322, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 145.55, "standard_charge_percentage": 37.0000, "estimated_amount": 145, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 314.7, "standard_charge_percentage": 80.0000, "estimated_amount": 314, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 295.04, "standard_charge_percentage": 75.0000, "estimated_amount": 295, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 196.69, "standard_charge_percentage": 50.0000, "estimated_amount": 196, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Mac Addl 15 Min", "code_information": [ { "code": "37000006", "type": "CDM" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 98.34,"minimum": 27.81,"maximum": 393.38,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 86.05, "standard_charge_percentage": 87.5000, "estimated_amount": 86, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 98.34, "standard_charge_percentage": 100.0000, "estimated_amount": 98, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 73.75, "standard_charge_percentage": 75.0000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 68.84, "standard_charge_percentage": 70.0000, "estimated_amount": 68, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 55.07, "standard_charge_percentage": 56.0000, "estimated_amount": 55, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 73.75, "standard_charge_percentage": 75.0000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 59, "standard_charge_percentage": 60.0000, "estimated_amount": 59, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 49.17, "standard_charge_percentage": 50.0000, "estimated_amount": 49, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 88.51, "standard_charge_percentage": 90.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 88.51, "standard_charge_percentage": 90.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 83.59, "standard_charge_percentage": 85.0000, "estimated_amount": 83, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 68.84, "standard_charge_percentage": 70.0000, "estimated_amount": 68, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 96.37, "standard_charge_percentage": 98.0000, "estimated_amount": 96, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 73.75, "standard_charge_percentage": 75.0000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 88.51, "standard_charge_percentage": 90.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 98.34, "standard_charge_percentage": 100.0000, "estimated_amount": 98, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 93.42, "standard_charge_percentage": 95.0000, "estimated_amount": 93, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 68.84, "standard_charge_percentage": 70.0000, "estimated_amount": 68, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 88.51, "standard_charge_percentage": 90.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 73.75, "standard_charge_percentage": 75.0000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 49.17, "standard_charge_percentage": 50.0000, "estimated_amount": 49, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 39.34, "standard_charge_percentage": 40.0000, "estimated_amount": 39, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 86.05, "standard_charge_percentage": 87.5000, "estimated_amount": 86, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 59, "standard_charge_percentage": 60.0000, "estimated_amount": 59, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 78.67, "standard_charge_percentage": 80.0000, "estimated_amount": 78, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 29.5, "standard_charge_percentage": 30.0000, "estimated_amount": 29, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 73.75, "standard_charge_percentage": 75.0000, "estimated_amount": 73, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 80.64, "standard_charge_percentage": 82.0000, "estimated_amount": 80, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 57.04, "standard_charge_percentage": 58.0000, "estimated_amount": 57, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 36.39, "standard_charge_percentage": 37.0000, "estimated_amount": 36, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 88.51, "standard_charge_percentage": 90.0000, "estimated_amount": 88, "methodology": "percent of total billed charges" }]}]} , { "description": "ASPIRATION OF HEMATOMA", "code_information": [ { "code": "37182", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 12073.7,"minimum": 3622.11,"maximum": 12073.7,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 9658.96, "standard_charge_percentage": 80.0000, "estimated_amount": 9658, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 9055.27, "standard_charge_percentage": 75.0000, "estimated_amount": 9055, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 10866.3, "standard_charge_percentage": 90.0000, "estimated_amount": 10866, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 10564.5, "standard_charge_percentage": 87.5000, "estimated_amount": 10564, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 12073.7, "standard_charge_percentage": 100.0000, "estimated_amount": 12073, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 6761.27, "standard_charge_percentage": 56.0000, "estimated_amount": 6761, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 9055.27, "standard_charge_percentage": 75.0000, "estimated_amount": 9055, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 9658.96, "standard_charge_percentage": 80.0000, "estimated_amount": 9658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6036.85, "standard_charge_percentage": 50.0000, "estimated_amount": 6036, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 10262.7, "standard_charge_percentage": 85.0000, "estimated_amount": 10262, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 4829.48, "standard_charge_percentage": 40.0000, "estimated_amount": 4829, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 10564.5, "standard_charge_percentage": 87.5000, "estimated_amount": 10564, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 9658.96, "standard_charge_percentage": 80.0000, "estimated_amount": 9658, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 9658.96, "standard_charge_percentage": 80.0000, "estimated_amount": 9658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3622.11, "standard_charge_percentage": 30.0000, "estimated_amount": 3622, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 8451.59, "standard_charge_percentage": 70.0000, "estimated_amount": 8451, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 7002.75, "standard_charge_percentage": 58.0000, "estimated_amount": 7002, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 10866.3, "standard_charge_percentage": 90.0000, "estimated_amount": 10866, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 11470, "standard_charge_percentage": 95.0000, "estimated_amount": 11470, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 7244.22, "standard_charge_percentage": 60.0000, "estimated_amount": 7244, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 9658.96, "standard_charge_percentage": 80.0000, "estimated_amount": 9658, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 9658.96, "standard_charge_percentage": 80.0000, "estimated_amount": 9658, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 9055.27, "standard_charge_percentage": 75.0000, "estimated_amount": 9055, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 9055.27, "standard_charge_percentage": 75.0000, "estimated_amount": 9055, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 9900.43, "standard_charge_percentage": 82.0000, "estimated_amount": 9900, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 10866.3, "standard_charge_percentage": 90.0000, "estimated_amount": 10866, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 10866.3, "standard_charge_percentage": 90.0000, "estimated_amount": 10866, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 11832.2, "standard_charge_percentage": 98.0000, "estimated_amount": 11832, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5302, "estimated_amount": 5302, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 10866.3, "standard_charge_percentage": 90.0000, "estimated_amount": 10866, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 9658.96, "standard_charge_percentage": 80.0000, "estimated_amount": 9658, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 12073.7, "standard_charge_percentage": 100.0000, "estimated_amount": 12073, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 9658.96, "standard_charge_percentage": 80.0000, "estimated_amount": 9658, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 9658.96, "standard_charge_percentage": 80.0000, "estimated_amount": 9658, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 8451.59, "standard_charge_percentage": 70.0000, "estimated_amount": 8451, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 8451.59, "standard_charge_percentage": 70.0000, "estimated_amount": 8451, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 4467.27, "standard_charge_percentage": 37.0000, "estimated_amount": 4467, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 9658.96, "standard_charge_percentage": 80.0000, "estimated_amount": 9658, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 9055.27, "standard_charge_percentage": 75.0000, "estimated_amount": 9055, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 7244.22, "standard_charge_percentage": 60.0000, "estimated_amount": 7244, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Prim Perc Mech Thrombectomy, Arterial", "code_information": [ { "code": "37184", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18554, "discounted_cash": 21959,"minimum": 2362.82,"maximum": 18554,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7421.6, "standard_charge_percentage": 40.0000, "estimated_amount": 7421, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 16234.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10390.2, "standard_charge_percentage": 56.0000, "estimated_amount": 10390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 17230.1, "estimated_amount": 17230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5302, "estimated_amount": 5302, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 15770.9, "standard_charge_percentage": 85.0000, "estimated_amount": 15770, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 15214.3, "standard_charge_percentage": 82.0000, "estimated_amount": 15214, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 6864.98, "standard_charge_percentage": 37.0000, "estimated_amount": 6864, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 11132.4, "standard_charge_percentage": 60.0000, "estimated_amount": 11132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2362.82, "estimated_amount": 2362, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 16234.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 18554, "standard_charge_percentage": 100.0000, "estimated_amount": 18554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 17626.3, "standard_charge_percentage": 95.0000, "estimated_amount": 17626, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5566.2, "standard_charge_percentage": 30.0000, "estimated_amount": 5566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 10761.3, "standard_charge_percentage": 58.0000, "estimated_amount": 10761, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9277, "standard_charge_percentage": 50.0000, "estimated_amount": 9277, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 18554, "standard_charge_percentage": 100.0000, "estimated_amount": 18554, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 11132.4, "standard_charge_percentage": 60.0000, "estimated_amount": 11132, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 18182.9, "standard_charge_percentage": 98.0000, "estimated_amount": 18182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" }]}]} , { "description": "Hc Prim Art M-Thrombect Add-On", "code_information": [ { "code": "37185", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5472.93,"minimum": 771.9,"maximum": 5472.93,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 771.9, "estimated_amount": 771, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4378.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2736.47, "standard_charge_percentage": 50.0000, "estimated_amount": 2736, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 4925.64, "standard_charge_percentage": 90.0000, "estimated_amount": 4925, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4378.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4378.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5199.28, "standard_charge_percentage": 95.0000, "estimated_amount": 5199, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5472.93, "standard_charge_percentage": 100.0000, "estimated_amount": 5472, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3283.76, "standard_charge_percentage": 60.0000, "estimated_amount": 3283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4104.7, "standard_charge_percentage": 75.0000, "estimated_amount": 4104, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4104.7, "standard_charge_percentage": 75.0000, "estimated_amount": 4104, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3064.84, "standard_charge_percentage": 56.0000, "estimated_amount": 3064, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 4925.64, "standard_charge_percentage": 90.0000, "estimated_amount": 4925, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4104.7, "standard_charge_percentage": 75.0000, "estimated_amount": 4104, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 4925.64, "standard_charge_percentage": 90.0000, "estimated_amount": 4925, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 4788.81, "standard_charge_percentage": 87.5000, "estimated_amount": 4788, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4378.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4378.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1641.88, "standard_charge_percentage": 30.0000, "estimated_amount": 1641, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3831.05, "standard_charge_percentage": 70.0000, "estimated_amount": 3831, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3831.05, "standard_charge_percentage": 70.0000, "estimated_amount": 3831, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4487.8, "standard_charge_percentage": 82.0000, "estimated_amount": 4487, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3174.3, "standard_charge_percentage": 58.0000, "estimated_amount": 3174, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4378.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4651.99, "standard_charge_percentage": 85.0000, "estimated_amount": 4651, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 4788.81, "standard_charge_percentage": 87.5000, "estimated_amount": 4788, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3831.05, "standard_charge_percentage": 70.0000, "estimated_amount": 3831, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2024.98, "standard_charge_percentage": 37.0000, "estimated_amount": 2024, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 4925.64, "standard_charge_percentage": 90.0000, "estimated_amount": 4925, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5363.47, "standard_charge_percentage": 98.0000, "estimated_amount": 5363, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3283.76, "standard_charge_percentage": 60.0000, "estimated_amount": 3283, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4378.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4104.7, "standard_charge_percentage": 75.0000, "estimated_amount": 4104, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 4925.64, "standard_charge_percentage": 90.0000, "estimated_amount": 4925, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2189.17, "standard_charge_percentage": 40.0000, "estimated_amount": 2189, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4378.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5472.93, "standard_charge_percentage": 100.0000, "estimated_amount": 5472, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4378.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4378.34, "standard_charge_percentage": 80.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4104.7, "standard_charge_percentage": 75.0000, "estimated_amount": 4104, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Sec Perc Mech Thrombect, Arterial, W Other Proc", "code_information": [ { "code": "37186", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5755.17,"minimum": 1662,"maximum": 5755.17,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4604.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4604, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2302.07, "standard_charge_percentage": 40.0000, "estimated_amount": 2302, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4028.62, "standard_charge_percentage": 70.0000, "estimated_amount": 4028, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4028.62, "standard_charge_percentage": 70.0000, "estimated_amount": 4028, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2129.41, "standard_charge_percentage": 37.0000, "estimated_amount": 2129, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5179.65, "standard_charge_percentage": 90.0000, "estimated_amount": 5179, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4316.38, "standard_charge_percentage": 75.0000, "estimated_amount": 4316, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4316.38, "standard_charge_percentage": 75.0000, "estimated_amount": 4316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2877.59, "standard_charge_percentage": 50.0000, "estimated_amount": 2877, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5179.65, "standard_charge_percentage": 90.0000, "estimated_amount": 5179, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4604.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4604, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4028.62, "standard_charge_percentage": 70.0000, "estimated_amount": 4028, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5179.65, "standard_charge_percentage": 90.0000, "estimated_amount": 5179, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4604.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4604, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5035.77, "standard_charge_percentage": 87.5000, "estimated_amount": 5035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5035.77, "standard_charge_percentage": 87.5000, "estimated_amount": 5035, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4604.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4604, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5755.17, "standard_charge_percentage": 100.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5755.17, "standard_charge_percentage": 100.0000, "estimated_amount": 5755, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4604.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4604, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4604.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4604, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4604.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4604, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4719.24, "standard_charge_percentage": 82.0000, "estimated_amount": 4719, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3222.9, "standard_charge_percentage": 56.0000, "estimated_amount": 3222, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4604.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4604, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5179.65, "standard_charge_percentage": 90.0000, "estimated_amount": 5179, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5179.65, "standard_charge_percentage": 90.0000, "estimated_amount": 5179, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4891.89, "standard_charge_percentage": 85.0000, "estimated_amount": 4891, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4604.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4604, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5467.41, "standard_charge_percentage": 95.0000, "estimated_amount": 5467, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3453.1, "standard_charge_percentage": 60.0000, "estimated_amount": 3453, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4604.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4604, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1726.55, "standard_charge_percentage": 30.0000, "estimated_amount": 1726, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4316.38, "standard_charge_percentage": 75.0000, "estimated_amount": 4316, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4316.38, "standard_charge_percentage": 75.0000, "estimated_amount": 4316, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3338, "standard_charge_percentage": 58.0000, "estimated_amount": 3338, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5640.07, "standard_charge_percentage": 98.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4316.38, "standard_charge_percentage": 75.0000, "estimated_amount": 4316, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3453.1, "standard_charge_percentage": 60.0000, "estimated_amount": 3453, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Perq Mechan Thrombectomy Venous", "code_information": [ { "code": "37187", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 17070.5, "discounted_cash": 13868,"minimum": 2297.57,"maximum": 17070.5,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5302, "estimated_amount": 5302, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 12802.9, "standard_charge_percentage": 75.0000, "estimated_amount": 12802, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 13656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13656, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 12802.9, "standard_charge_percentage": 75.0000, "estimated_amount": 12802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 13656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13656, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 15363.5, "standard_charge_percentage": 90.0000, "estimated_amount": 15363, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 14509.9, "standard_charge_percentage": 85.0000, "estimated_amount": 14509, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 13656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13656, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 13656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13656, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 17070.5, "standard_charge_percentage": 100.0000, "estimated_amount": 17070, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 13656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13656, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 11949.4, "standard_charge_percentage": 70.0000, "estimated_amount": 11949, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 11949.4, "standard_charge_percentage": 70.0000, "estimated_amount": 11949, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9900.89, "standard_charge_percentage": 58.0000, "estimated_amount": 9900, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 13656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13656, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 15363.5, "standard_charge_percentage": 90.0000, "estimated_amount": 15363, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10881.7, "estimated_amount": 10881, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 17070.5, "estimated_amount": 17070, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2297.57, "estimated_amount": 2297, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 14018, "estimated_amount": 14018, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 8535.25, "standard_charge_percentage": 50.0000, "estimated_amount": 8535, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6828.2, "standard_charge_percentage": 40.0000, "estimated_amount": 6828, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 14936.7, "standard_charge_percentage": 87.5000, "estimated_amount": 14936, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 16217, "standard_charge_percentage": 95.0000, "estimated_amount": 16216, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 10242.3, "standard_charge_percentage": 60.0000, "estimated_amount": 10242, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 13656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13656, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 13656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13656, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 11949.4, "standard_charge_percentage": 70.0000, "estimated_amount": 11949, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 12802.9, "standard_charge_percentage": 75.0000, "estimated_amount": 12802, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 16729.1, "standard_charge_percentage": 98.0000, "estimated_amount": 16729, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 10242.3, "standard_charge_percentage": 60.0000, "estimated_amount": 10242, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 14402.2, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 13824.7, "estimated_amount": 13824, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 15363.5, "standard_charge_percentage": 90.0000, "estimated_amount": 15363, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 14936.7, "standard_charge_percentage": 87.5000, "estimated_amount": 14936, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 13656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 13656.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13656, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5121.15, "standard_charge_percentage": 30.0000, "estimated_amount": 5121, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 13997.8, "standard_charge_percentage": 82.0000, "estimated_amount": 13997, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 13921.4, "estimated_amount": 13921, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 15363.5, "standard_charge_percentage": 90.0000, "estimated_amount": 15363, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 17070.5, "standard_charge_percentage": 100.0000, "estimated_amount": 17070, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 12802.9, "standard_charge_percentage": 75.0000, "estimated_amount": 12802, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 9559.48, "standard_charge_percentage": 56.0000, "estimated_amount": 9559, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 6316.09, "standard_charge_percentage": 37.0000, "estimated_amount": 6316, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 15363.5, "standard_charge_percentage": 90.0000, "estimated_amount": 15363, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 12802.9, "standard_charge_percentage": 75.0000, "estimated_amount": 12802, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 17070.5, "estimated_amount": 17070, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 17070.5, "estimated_amount": 17070, "methodology": "fee schedule" }]}]} , { "description": "Hc Insert Intrvas Vc Filtr W Vasc Acs Vssl Rs&I", "code_information": [ { "code": "37191", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 15561.7, "discounted_cash": 6610,"minimum": 2091.09,"maximum": 15561.7,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 6635.89, "estimated_amount": 6635, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 11671.3, "standard_charge_percentage": 75.0000, "estimated_amount": 11671, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 14005.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14005, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 13616.5, "standard_charge_percentage": 87.5000, "estimated_amount": 13616, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 12449.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12449, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 12449.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12449, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4668.51, "standard_charge_percentage": 30.0000, "estimated_amount": 4668, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 10893.2, "standard_charge_percentage": 70.0000, "estimated_amount": 10893, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 7119.35, "estimated_amount": 7119, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 5186.95, "estimated_amount": 5186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 6681.98, "estimated_amount": 6681, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 11671.3, "standard_charge_percentage": 75.0000, "estimated_amount": 11671, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 12449.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12449, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12449.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12449, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 13616.5, "standard_charge_percentage": 87.5000, "estimated_amount": 13616, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12449.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12449, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8714.55, "standard_charge_percentage": 56.0000, "estimated_amount": 8714, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 14005.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14005, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 11671.3, "standard_charge_percentage": 75.0000, "estimated_amount": 11671, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 9337.02, "standard_charge_percentage": 60.0000, "estimated_amount": 9337, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 5339.51, "estimated_amount": 5339, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 6865.09, "estimated_amount": 6865, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 10170.5, "estimated_amount": 10170, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 4608.26, "estimated_amount": 4608, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2091.09, "estimated_amount": 2091, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 14005.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14005, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 14005.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14005, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6224.68, "standard_charge_percentage": 40.0000, "estimated_amount": 6224, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 12449.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12449, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 12449.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12449, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 15561.7, "standard_charge_percentage": 100.0000, "estimated_amount": 15561, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 15561.7, "standard_charge_percentage": 100.0000, "estimated_amount": 15561, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 9337.02, "standard_charge_percentage": 60.0000, "estimated_amount": 9337, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 12449.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12449, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 10893.2, "standard_charge_percentage": 70.0000, "estimated_amount": 10893, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 11671.3, "standard_charge_percentage": 75.0000, "estimated_amount": 11671, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 12760.6, "standard_charge_percentage": 82.0000, "estimated_amount": 12760, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9025.79, "standard_charge_percentage": 58.0000, "estimated_amount": 9025, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 5757.83, "standard_charge_percentage": 37.0000, "estimated_amount": 5757, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12449.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12449, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 15250.5, "standard_charge_percentage": 98.0000, "estimated_amount": 15250, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 15561.7, "estimated_amount": 15561, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 7119.35, "estimated_amount": 7119, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9407.71, "estimated_amount": 9407, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 5153.11, "estimated_amount": 5153, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 4608.26, "estimated_amount": 4608, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 6589.81, "estimated_amount": 6589, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 7780.85, "standard_charge_percentage": 50.0000, "estimated_amount": 7780, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 13227.4, "standard_charge_percentage": 85.0000, "estimated_amount": 13227, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 14783.6, "standard_charge_percentage": 95.0000, "estimated_amount": 14783, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 12449.4, "standard_charge_percentage": 80.0000, "estimated_amount": 12449, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 11671.3, "standard_charge_percentage": 75.0000, "estimated_amount": 11671, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 10893.2, "standard_charge_percentage": 70.0000, "estimated_amount": 10893, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 14005.5, "standard_charge_percentage": 90.0000, "estimated_amount": 14005, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 8136.4, "estimated_amount": 8136, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 5339.51, "estimated_amount": 5339, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 8136.4, "estimated_amount": 8136, "methodology": "fee schedule" }]}]} , { "description": "Hc Rtrvl Intrvas Vc Filtr W/Wo Acs Vsl Selxn Rs&I", "code_information": [ { "code": "37193", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 15802, "discounted_cash": 3849,"minimum": 1435.47,"maximum": 15802,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12641.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12641, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 14221.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14221, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6320.8, "standard_charge_percentage": 40.0000, "estimated_amount": 6320, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 12641.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12641, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 15802, "standard_charge_percentage": 100.0000, "estimated_amount": 15802, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 12641.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12641, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 12957.6, "standard_charge_percentage": 82.0000, "estimated_amount": 12957, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 14221.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14221, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 11851.5, "standard_charge_percentage": 75.0000, "estimated_amount": 11851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 9481.2, "standard_charge_percentage": 60.0000, "estimated_amount": 9481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 11851.5, "standard_charge_percentage": 75.0000, "estimated_amount": 11851, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 13431.7, "standard_charge_percentage": 85.0000, "estimated_amount": 13431, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 12641.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12641.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4740.6, "standard_charge_percentage": 30.0000, "estimated_amount": 4740, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 5846.74, "standard_charge_percentage": 37.0000, "estimated_amount": 5846, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 15486, "standard_charge_percentage": 98.0000, "estimated_amount": 15485, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 10484.2, "estimated_amount": 10484, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 12641.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12641, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 11851.5, "standard_charge_percentage": 75.0000, "estimated_amount": 11851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 7901, "standard_charge_percentage": 50.0000, "estimated_amount": 7901, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 13826.8, "standard_charge_percentage": 87.5000, "estimated_amount": 13826, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 13826.8, "standard_charge_percentage": 87.5000, "estimated_amount": 13826, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 15802, "standard_charge_percentage": 100.0000, "estimated_amount": 15802, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 12641.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12641, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 11061.4, "standard_charge_percentage": 70.0000, "estimated_amount": 11061, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 11061.4, "standard_charge_percentage": 70.0000, "estimated_amount": 11061, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 11851.5, "standard_charge_percentage": 75.0000, "estimated_amount": 11851, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9165.16, "standard_charge_percentage": 58.0000, "estimated_amount": 9165, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12641.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1435.47, "estimated_amount": 1435, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 14221.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14221, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 14221.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14221, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 12641.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12641, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 15011.9, "standard_charge_percentage": 95.0000, "estimated_amount": 15011, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 9481.2, "standard_charge_percentage": 60.0000, "estimated_amount": 9481, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 12641.6, "standard_charge_percentage": 80.0000, "estimated_amount": 12641, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 11851.5, "standard_charge_percentage": 75.0000, "estimated_amount": 11851, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 11061.4, "standard_charge_percentage": 70.0000, "estimated_amount": 11061, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8849.12, "standard_charge_percentage": 56.0000, "estimated_amount": 8849, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 14221.8, "standard_charge_percentage": 90.0000, "estimated_amount": 14221, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" }]}]} , { "description": "NB OCCIPITAL LT-PC", "code_information": [ { "code": "37195", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 1700.39, "discounted_cash": 405,"minimum": 282.76,"maximum": 1700.39,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 407.17, "estimated_amount": 407, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 333.48, "estimated_amount": 333, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 282.76, "estimated_amount": 282, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 1530.35, "standard_charge_percentage": 90.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 1360.31, "standard_charge_percentage": 80.0000, "estimated_amount": 1360, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 1360.31, "standard_charge_percentage": 80.0000, "estimated_amount": 1360, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 952.22, "standard_charge_percentage": 56.0000, "estimated_amount": 952, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 986.23, "standard_charge_percentage": 58.0000, "estimated_amount": 986, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 850.2, "standard_charge_percentage": 50.0000, "estimated_amount": 850, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 624.04, "estimated_amount": 624, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 282.76, "estimated_amount": 282, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 1360.31, "standard_charge_percentage": 80.0000, "estimated_amount": 1360, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 1530.35, "standard_charge_percentage": 90.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 680.16, "standard_charge_percentage": 40.0000, "estimated_amount": 680, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 1487.84, "standard_charge_percentage": 87.5000, "estimated_amount": 1487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 1615.37, "standard_charge_percentage": 95.0000, "estimated_amount": 1615, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 1700.39, "standard_charge_percentage": 100.0000, "estimated_amount": 1700, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 1360.31, "standard_charge_percentage": 80.0000, "estimated_amount": 1360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 510.12, "standard_charge_percentage": 30.0000, "estimated_amount": 510, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 1360.31, "standard_charge_percentage": 80.0000, "estimated_amount": 1360, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 436.83, "estimated_amount": 436, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 1104.82, "estimated_amount": 1104, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 434.19, "estimated_amount": 434, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 410, "estimated_amount": 410, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 1275.29, "standard_charge_percentage": 75.0000, "estimated_amount": 1275, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 1275.29, "standard_charge_percentage": 75.0000, "estimated_amount": 1275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 850.2, "standard_charge_percentage": 50.0000, "estimated_amount": 850, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 1360.31, "standard_charge_percentage": 80.0000, "estimated_amount": 1360, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 1700.39, "standard_charge_percentage": 100.0000, "estimated_amount": 1700, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 1360.31, "standard_charge_percentage": 80.0000, "estimated_amount": 1360, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 1275.29, "standard_charge_percentage": 75.0000, "estimated_amount": 1275, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 1190.27, "standard_charge_percentage": 70.0000, "estimated_amount": 1190, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 1394.32, "standard_charge_percentage": 82.0000, "estimated_amount": 1394, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 629.14, "standard_charge_percentage": 37.0000, "estimated_amount": 629, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 1530.35, "standard_charge_percentage": 90.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 1530.35, "standard_charge_percentage": 90.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 1666.38, "standard_charge_percentage": 98.0000, "estimated_amount": 1666, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 1275.29, "standard_charge_percentage": 75.0000, "estimated_amount": 1275, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 1020.23, "standard_charge_percentage": 60.0000, "estimated_amount": 1020, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 318.26, "estimated_amount": 318, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 499.23, "estimated_amount": 499, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 327.62, "estimated_amount": 327, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 436.83, "estimated_amount": 436, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 499.23, "estimated_amount": 499, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 404.35, "estimated_amount": 404, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 1360.31, "standard_charge_percentage": 80.0000, "estimated_amount": 1360, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 1530.35, "standard_charge_percentage": 90.0000, "estimated_amount": 1530, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 1445.33, "standard_charge_percentage": 85.0000, "estimated_amount": 1445, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 1487.84, "standard_charge_percentage": 87.5000, "estimated_amount": 1487, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 1360.31, "standard_charge_percentage": 80.0000, "estimated_amount": 1360, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 1360.31, "standard_charge_percentage": 80.0000, "estimated_amount": 1360, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 1020.23, "standard_charge_percentage": 60.0000, "estimated_amount": 1020, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 1190.27, "standard_charge_percentage": 70.0000, "estimated_amount": 1190, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 1190.27, "standard_charge_percentage": 70.0000, "estimated_amount": 1190, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 1275.29, "standard_charge_percentage": 75.0000, "estimated_amount": 1275, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 327.62, "estimated_amount": 327, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 421.23, "estimated_amount": 421, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 312.02, "estimated_amount": 312, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 577.24, "estimated_amount": 577, "methodology": "fee schedule" }]}]} , { "description": "Hc Transcatheter Biopsy", "code_information": [ { "code": "37200", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 15967.9, "discounted_cash": 6610,"minimum": 1780.21,"maximum": 15967.9,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12774.3, "standard_charge_percentage": 80.0000, "estimated_amount": 12774, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 14371.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14371, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 13971.9, "standard_charge_percentage": 87.5000, "estimated_amount": 13971, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 12774.3, "standard_charge_percentage": 80.0000, "estimated_amount": 12774, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 15967.9, "standard_charge_percentage": 100.0000, "estimated_amount": 15967, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12774.3, "standard_charge_percentage": 80.0000, "estimated_amount": 12774, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 12774.3, "standard_charge_percentage": 80.0000, "estimated_amount": 12774, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 12774.3, "standard_charge_percentage": 80.0000, "estimated_amount": 12774, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 12774.3, "standard_charge_percentage": 80.0000, "estimated_amount": 12774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 11975.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11975, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 11177.5, "standard_charge_percentage": 70.0000, "estimated_amount": 11177, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 5339.51, "estimated_amount": 5339, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 8136.4, "estimated_amount": 8136, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 12774.3, "standard_charge_percentage": 80.0000, "estimated_amount": 12774, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 7983.95, "standard_charge_percentage": 50.0000, "estimated_amount": 7983, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 14371.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14371, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 9580.74, "standard_charge_percentage": 60.0000, "estimated_amount": 9580, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4790.37, "standard_charge_percentage": 30.0000, "estimated_amount": 4790, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 11177.5, "standard_charge_percentage": 70.0000, "estimated_amount": 11177, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 13093.7, "standard_charge_percentage": 82.0000, "estimated_amount": 13093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12774.3, "standard_charge_percentage": 80.0000, "estimated_amount": 12774, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 14371.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14371, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 9580.74, "standard_charge_percentage": 60.0000, "estimated_amount": 9580, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 6865.09, "estimated_amount": 6865, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 8136.4, "estimated_amount": 8136, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9407.71, "estimated_amount": 9407, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 6635.89, "estimated_amount": 6635, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 5153.11, "estimated_amount": 5153, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 4608.26, "estimated_amount": 4608, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 6589.81, "estimated_amount": 6589, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 11975.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11975, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 11975.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11975, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 14371.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14371, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 13572.7, "standard_charge_percentage": 85.0000, "estimated_amount": 13572, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 15967.9, "standard_charge_percentage": 100.0000, "estimated_amount": 15967, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 11177.5, "standard_charge_percentage": 70.0000, "estimated_amount": 11177, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9261.38, "standard_charge_percentage": 58.0000, "estimated_amount": 9261, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 5908.12, "standard_charge_percentage": 37.0000, "estimated_amount": 5908, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 14371.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14371, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 11975.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11975, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 7119.35, "estimated_amount": 7119, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 15967.9, "estimated_amount": 15967, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 5339.51, "estimated_amount": 5339, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 5186.95, "estimated_amount": 5186, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 4608.26, "estimated_amount": 4608, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1780.21, "estimated_amount": 1780, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 6681.98, "estimated_amount": 6681, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6387.16, "standard_charge_percentage": 40.0000, "estimated_amount": 6387, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 13971.9, "standard_charge_percentage": 87.5000, "estimated_amount": 13971, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 12774.3, "standard_charge_percentage": 80.0000, "estimated_amount": 12774, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 12774.3, "standard_charge_percentage": 80.0000, "estimated_amount": 12774, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 15169.5, "standard_charge_percentage": 95.0000, "estimated_amount": 15169, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 11975.9, "standard_charge_percentage": 75.0000, "estimated_amount": 11975, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8942.02, "standard_charge_percentage": 56.0000, "estimated_amount": 8942, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 15648.5, "standard_charge_percentage": 98.0000, "estimated_amount": 15648, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 7119.35, "estimated_amount": 7119, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 10170.5, "estimated_amount": 10170, "methodology": "fee schedule" }]}]} , { "description": "Hc Thrombolysis Arterial Infusion W/Img Init Tx", "code_information": [ { "code": "37211", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 15969, "discounted_cash": 6610,"minimum": 531.39,"maximum": 15969,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 4608.26, "estimated_amount": 4608, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 5153.11, "estimated_amount": 5153, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 531.39, "estimated_amount": 531, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 6681.98, "estimated_amount": 6681, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 7984.5, "standard_charge_percentage": 50.0000, "estimated_amount": 7984, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 14372.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14372, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 13573.7, "standard_charge_percentage": 85.0000, "estimated_amount": 13573, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 13972.9, "standard_charge_percentage": 87.5000, "estimated_amount": 13972, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 13972.9, "standard_charge_percentage": 87.5000, "estimated_amount": 13972, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 12775.2, "standard_charge_percentage": 80.0000, "estimated_amount": 12775, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 5908.53, "standard_charge_percentage": 37.0000, "estimated_amount": 5908, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 7119.35, "estimated_amount": 7119, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 5186.95, "estimated_amount": 5186, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 7119.35, "estimated_amount": 7119, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 6635.89, "estimated_amount": 6635, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 4608.26, "estimated_amount": 4608, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 6589.81, "estimated_amount": 6589, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 11976.8, "standard_charge_percentage": 75.0000, "estimated_amount": 11976, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 14372.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14372, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6387.6, "standard_charge_percentage": 40.0000, "estimated_amount": 6387, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 12775.2, "standard_charge_percentage": 80.0000, "estimated_amount": 12775, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 12775.2, "standard_charge_percentage": 80.0000, "estimated_amount": 12775, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 11178.3, "standard_charge_percentage": 70.0000, "estimated_amount": 11178, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 11178.3, "standard_charge_percentage": 70.0000, "estimated_amount": 11178, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 13094.6, "standard_charge_percentage": 82.0000, "estimated_amount": 13094, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9262.02, "standard_charge_percentage": 58.0000, "estimated_amount": 9262, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 11976.8, "standard_charge_percentage": 75.0000, "estimated_amount": 11976, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 15969, "estimated_amount": 15969, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 5339.51, "estimated_amount": 5339, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 6865.09, "estimated_amount": 6865, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 10170.5, "estimated_amount": 10170, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 11976.8, "standard_charge_percentage": 75.0000, "estimated_amount": 11976, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 12775.2, "standard_charge_percentage": 80.0000, "estimated_amount": 12775, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 12775.2, "standard_charge_percentage": 80.0000, "estimated_amount": 12775, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 15969, "standard_charge_percentage": 100.0000, "estimated_amount": 15969, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 15170.5, "standard_charge_percentage": 95.0000, "estimated_amount": 15170, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 9581.4, "standard_charge_percentage": 60.0000, "estimated_amount": 9581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 12775.2, "standard_charge_percentage": 80.0000, "estimated_amount": 12775, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 12775.2, "standard_charge_percentage": 80.0000, "estimated_amount": 12775, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 11178.3, "standard_charge_percentage": 70.0000, "estimated_amount": 11178, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 14372.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14372, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 9581.4, "standard_charge_percentage": 60.0000, "estimated_amount": 9581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 8136.4, "estimated_amount": 8136, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 5339.51, "estimated_amount": 5339, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 12775.2, "standard_charge_percentage": 80.0000, "estimated_amount": 12775, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 14372.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14372, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 15969, "standard_charge_percentage": 100.0000, "estimated_amount": 15969, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 12775.2, "standard_charge_percentage": 80.0000, "estimated_amount": 12775, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4790.7, "standard_charge_percentage": 30.0000, "estimated_amount": 4790, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 11976.8, "standard_charge_percentage": 75.0000, "estimated_amount": 11976, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 11976.8, "standard_charge_percentage": 75.0000, "estimated_amount": 11976, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8942.64, "standard_charge_percentage": 56.0000, "estimated_amount": 8942, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 12775.2, "standard_charge_percentage": 80.0000, "estimated_amount": 12775, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 14372.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14372, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 15649.6, "standard_charge_percentage": 98.0000, "estimated_amount": 15649, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 5085.25, "estimated_amount": 5085, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9407.71, "estimated_amount": 9407, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 8136.4, "estimated_amount": 8136, "methodology": "fee schedule" }]}]} , { "description": "Hc Thrombolysis Venous Infusion W/Imaging Init Tx", "code_information": [ { "code": "37212", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 9639, "discounted_cash": 3849,"minimum": 531.39,"maximum": 9639,"payers_information":[{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "case rate" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3855.6, "standard_charge_percentage": 40.0000, "estimated_amount": 3855, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 9639, "estimated_amount": 9639, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 9157.05, "standard_charge_percentage": 95.0000, "estimated_amount": 9157, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 9639, "standard_charge_percentage": 100.0000, "estimated_amount": 9639, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5783.4, "standard_charge_percentage": 60.0000, "estimated_amount": 5783, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2891.7, "standard_charge_percentage": 30.0000, "estimated_amount": 2891, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 5397.84, "standard_charge_percentage": 56.0000, "estimated_amount": 5397, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 3566.43, "standard_charge_percentage": 37.0000, "estimated_amount": 3566, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 5783.4, "standard_charge_percentage": 60.0000, "estimated_amount": 5783, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 8193.15, "standard_charge_percentage": 85.0000, "estimated_amount": 8193, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 8434.13, "standard_charge_percentage": 87.5000, "estimated_amount": 8434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 8434.13, "standard_charge_percentage": 87.5000, "estimated_amount": 8434, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 9639, "standard_charge_percentage": 100.0000, "estimated_amount": 9639, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 6747.3, "standard_charge_percentage": 70.0000, "estimated_amount": 6747, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 9446.22, "standard_charge_percentage": 98.0000, "estimated_amount": 9446, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 531.39, "estimated_amount": 531, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 7229.25, "standard_charge_percentage": 75.0000, "estimated_amount": 7229, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 4819.5, "standard_charge_percentage": 50.0000, "estimated_amount": 4819, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 7711.2, "standard_charge_percentage": 80.0000, "estimated_amount": 7711, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7903.98, "standard_charge_percentage": 82.0000, "estimated_amount": 7903, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 5590.62, "standard_charge_percentage": 58.0000, "estimated_amount": 5590, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 8675.1, "standard_charge_percentage": 90.0000, "estimated_amount": 8675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" }]}]} , { "description": "Hc Thrombolysis Art/Venous Infsn W/Image Subsq Tx", "code_information": [ { "code": "37213", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3990.53, "discounted_cash": 3849,"minimum": 1185.78,"maximum": 3990.53,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3391.95, "standard_charge_percentage": 85.0000, "estimated_amount": 3391, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3491.71, "standard_charge_percentage": 87.5000, "estimated_amount": 3491, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1197.16, "standard_charge_percentage": 30.0000, "estimated_amount": 1197, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3910.72, "standard_charge_percentage": 98.0000, "estimated_amount": 3910, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2394.32, "standard_charge_percentage": 60.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1185.78, "estimated_amount": 1185, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2394.32, "standard_charge_percentage": 60.0000, "estimated_amount": 2394, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2314.51, "standard_charge_percentage": 58.0000, "estimated_amount": 2314, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1476.5, "standard_charge_percentage": 37.0000, "estimated_amount": 1476, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3491.71, "standard_charge_percentage": 87.5000, "estimated_amount": 3491, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3990.53, "standard_charge_percentage": 100.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2234.7, "standard_charge_percentage": 56.0000, "estimated_amount": 2234, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1995.27, "standard_charge_percentage": 50.0000, "estimated_amount": 1995, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3591.48, "standard_charge_percentage": 90.0000, "estimated_amount": 3591, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1596.21, "standard_charge_percentage": 40.0000, "estimated_amount": 1596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3990.53, "standard_charge_percentage": 100.0000, "estimated_amount": 3990, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3791, "standard_charge_percentage": 95.0000, "estimated_amount": 3791, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3192.42, "standard_charge_percentage": 80.0000, "estimated_amount": 3192, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2793.37, "standard_charge_percentage": 70.0000, "estimated_amount": 2793, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2992.9, "standard_charge_percentage": 75.0000, "estimated_amount": 2992, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3272.23, "standard_charge_percentage": 82.0000, "estimated_amount": 3272, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 3990.53, "estimated_amount": 3990, "methodology": "fee schedule" }]}]} , { "description": "Hc Cessation Thrombolytic Thrpy W/Catheter Removal", "code_information": [ { "code": "37214", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 16416.8, "discounted_cash": 3849,"minimum": 1185.78,"maximum": 16416.8,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3863.78, "estimated_amount": 3863, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3836.95, "estimated_amount": 3836, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 8208.4, "standard_charge_percentage": 50.0000, "estimated_amount": 8208, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 6566.72, "standard_charge_percentage": 40.0000, "estimated_amount": 6566, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 14364.7, "standard_charge_percentage": 87.5000, "estimated_amount": 14364, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 13133.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13133, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 16416.8, "standard_charge_percentage": 100.0000, "estimated_amount": 16416, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 15596, "standard_charge_percentage": 95.0000, "estimated_amount": 15595, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 9850.08, "standard_charge_percentage": 60.0000, "estimated_amount": 9850, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 12312.6, "standard_charge_percentage": 75.0000, "estimated_amount": 12312, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 13461.8, "standard_charge_percentage": 82.0000, "estimated_amount": 13461, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 10484.2, "estimated_amount": 10484, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 4145.27, "estimated_amount": 4145, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 12312.6, "standard_charge_percentage": 75.0000, "estimated_amount": 12312, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 13133.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13133, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 13133.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13133, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 13954.3, "standard_charge_percentage": 85.0000, "estimated_amount": 13954, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 13133.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13133, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 13133.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13133, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 13133.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13133, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 11491.8, "standard_charge_percentage": 70.0000, "estimated_amount": 11491, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 16088.5, "standard_charge_percentage": 98.0000, "estimated_amount": 16088, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 9850.08, "standard_charge_percentage": 60.0000, "estimated_amount": 9850, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3997.23, "estimated_amount": 3997, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4737.46, "estimated_amount": 4737, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2986.71, "estimated_amount": 2986, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1185.78, "estimated_amount": 1185, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2683.18, "estimated_amount": 2683, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 12312.6, "standard_charge_percentage": 75.0000, "estimated_amount": 12312, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 14775.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14775, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 14775.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14775, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 16416.8, "standard_charge_percentage": 100.0000, "estimated_amount": 16416, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 13133.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13133, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 12312.6, "standard_charge_percentage": 75.0000, "estimated_amount": 12312, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 9521.74, "standard_charge_percentage": 58.0000, "estimated_amount": 9521, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 13133.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13133, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 14775.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14775, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 14775.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14775, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 12312.6, "standard_charge_percentage": 75.0000, "estimated_amount": 12312, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3020.13, "estimated_amount": 3020, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5477.68, "estimated_amount": 5477, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3890.61, "estimated_amount": 3890, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 14775.1, "standard_charge_percentage": 90.0000, "estimated_amount": 14775, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 14364.7, "standard_charge_percentage": 87.5000, "estimated_amount": 14364, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 13133.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13133, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 13133.4, "standard_charge_percentage": 80.0000, "estimated_amount": 13133, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4925.04, "standard_charge_percentage": 30.0000, "estimated_amount": 4925, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 11491.8, "standard_charge_percentage": 70.0000, "estimated_amount": 11491, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 11491.8, "standard_charge_percentage": 70.0000, "estimated_amount": 11491, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 9193.41, "standard_charge_percentage": 56.0000, "estimated_amount": 9193, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 6074.22, "standard_charge_percentage": 37.0000, "estimated_amount": 6074, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3108.96, "estimated_amount": 3108, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2960.91, "estimated_amount": 2960, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5921.82, "estimated_amount": 5921, "methodology": "fee schedule" }]}]} , { "description": "Hc Revasc Iliac Art Angiopl/Stnt Init Vssl", "code_information": [ { "code": "37221", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 56048.6, "discounted_cash": 13868,"minimum": 2031.33,"maximum": 56048.6,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 13921.4, "estimated_amount": 13921, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 14018, "estimated_amount": 14018, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 42036.4, "standard_charge_percentage": 75.0000, "estimated_amount": 42036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 44838.9, "standard_charge_percentage": 80.0000, "estimated_amount": 44838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 28024.3, "standard_charge_percentage": 50.0000, "estimated_amount": 28024, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 49042.5, "standard_charge_percentage": 87.5000, "estimated_amount": 49042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 44838.9, "standard_charge_percentage": 80.0000, "estimated_amount": 44838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 42036.4, "standard_charge_percentage": 75.0000, "estimated_amount": 42036, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 31387.2, "standard_charge_percentage": 56.0000, "estimated_amount": 31387, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 21336.6, "estimated_amount": 21336, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 42036.4, "standard_charge_percentage": 75.0000, "estimated_amount": 42036, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 50443.7, "standard_charge_percentage": 90.0000, "estimated_amount": 50443, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 50443.7, "standard_charge_percentage": 90.0000, "estimated_amount": 50443, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 47641.3, "standard_charge_percentage": 85.0000, "estimated_amount": 47641, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 22419.4, "standard_charge_percentage": 40.0000, "estimated_amount": 22419, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 49042.5, "standard_charge_percentage": 87.5000, "estimated_amount": 49042, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 56048.6, "standard_charge_percentage": 100.0000, "estimated_amount": 56048, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 53246.2, "standard_charge_percentage": 95.0000, "estimated_amount": 53246, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 44838.9, "standard_charge_percentage": 80.0000, "estimated_amount": 44838, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 16814.6, "standard_charge_percentage": 30.0000, "estimated_amount": 16814, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 39234, "standard_charge_percentage": 70.0000, "estimated_amount": 39234, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 14402.2, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "case rate" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 13824.7, "estimated_amount": 13824, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 44838.9, "standard_charge_percentage": 80.0000, "estimated_amount": 44838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 44838.9, "standard_charge_percentage": 80.0000, "estimated_amount": 44838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 44838.9, "standard_charge_percentage": 80.0000, "estimated_amount": 44838, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 33629.2, "standard_charge_percentage": 60.0000, "estimated_amount": 33629, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 44838.9, "standard_charge_percentage": 80.0000, "estimated_amount": 44838, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 44838.9, "standard_charge_percentage": 80.0000, "estimated_amount": 44838, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 39234, "standard_charge_percentage": 70.0000, "estimated_amount": 39234, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 20738, "standard_charge_percentage": 37.0000, "estimated_amount": 20737, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 50443.7, "standard_charge_percentage": 90.0000, "estimated_amount": 50443, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 42036.4, "standard_charge_percentage": 75.0000, "estimated_amount": 42036, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 33629.2, "standard_charge_percentage": 60.0000, "estimated_amount": 33629, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 37775, "estimated_amount": 37775, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 19736.3, "estimated_amount": 19736, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2031.33, "estimated_amount": 2031, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 50443.7, "standard_charge_percentage": 90.0000, "estimated_amount": 50443, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 44838.9, "standard_charge_percentage": 80.0000, "estimated_amount": 44838, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 56048.6, "standard_charge_percentage": 100.0000, "estimated_amount": 56048, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 39234, "standard_charge_percentage": 70.0000, "estimated_amount": 39234, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 42036.4, "standard_charge_percentage": 75.0000, "estimated_amount": 42036, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 45959.8, "standard_charge_percentage": 82.0000, "estimated_amount": 45959, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 32508.2, "standard_charge_percentage": 58.0000, "estimated_amount": 32508, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 44838.9, "standard_charge_percentage": 80.0000, "estimated_amount": 44838, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 50443.7, "standard_charge_percentage": 90.0000, "estimated_amount": 50443, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 54927.6, "standard_charge_percentage": 98.0000, "estimated_amount": 54927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10881.7, "estimated_amount": 10881, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" }]}]} , { "description": "Hc Revasc Iliac Art Angioplasty/Stnt Ea Add Vssl", "code_information": [ { "code": "37223", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 12092.1,"minimum": 1662,"maximum": 12092.1,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2031.33, "estimated_amount": 2031, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 4836.84, "standard_charge_percentage": 40.0000, "estimated_amount": 4836, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 9673.68, "standard_charge_percentage": 80.0000, "estimated_amount": 9673, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 11487.5, "standard_charge_percentage": 95.0000, "estimated_amount": 11487, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 7255.26, "standard_charge_percentage": 60.0000, "estimated_amount": 7255, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 9673.68, "standard_charge_percentage": 80.0000, "estimated_amount": 9673, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 9069.08, "standard_charge_percentage": 75.0000, "estimated_amount": 9069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 9673.68, "standard_charge_percentage": 80.0000, "estimated_amount": 9673, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 11850.3, "standard_charge_percentage": 98.0000, "estimated_amount": 11850, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 9673.68, "standard_charge_percentage": 80.0000, "estimated_amount": 9673, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 9069.08, "standard_charge_percentage": 75.0000, "estimated_amount": 9069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 9673.68, "standard_charge_percentage": 80.0000, "estimated_amount": 9673, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 12092.1, "standard_charge_percentage": 100.0000, "estimated_amount": 12092, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 9673.68, "standard_charge_percentage": 80.0000, "estimated_amount": 9673, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 9673.68, "standard_charge_percentage": 80.0000, "estimated_amount": 9673, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 8464.47, "standard_charge_percentage": 70.0000, "estimated_amount": 8464, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 8464.47, "standard_charge_percentage": 70.0000, "estimated_amount": 8464, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 6771.58, "standard_charge_percentage": 56.0000, "estimated_amount": 6771, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 7013.42, "standard_charge_percentage": 58.0000, "estimated_amount": 7013, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 10882.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10882, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 9069.08, "standard_charge_percentage": 75.0000, "estimated_amount": 9069, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 10882.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10882, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 9673.68, "standard_charge_percentage": 80.0000, "estimated_amount": 9673, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 3627.63, "standard_charge_percentage": 30.0000, "estimated_amount": 3627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 9069.08, "standard_charge_percentage": 75.0000, "estimated_amount": 9069, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 4474.08, "standard_charge_percentage": 37.0000, "estimated_amount": 4474, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 10882.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10882, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 9069.08, "standard_charge_percentage": 75.0000, "estimated_amount": 9069, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 6046.05, "standard_charge_percentage": 50.0000, "estimated_amount": 6046, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 10882.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10882, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 10882.9, "standard_charge_percentage": 90.0000, "estimated_amount": 10882, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 10278.3, "standard_charge_percentage": 85.0000, "estimated_amount": 10278, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 10580.6, "standard_charge_percentage": 87.5000, "estimated_amount": 10580, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 10580.6, "standard_charge_percentage": 87.5000, "estimated_amount": 10580, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 9673.68, "standard_charge_percentage": 80.0000, "estimated_amount": 9673, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 12092.1, "standard_charge_percentage": 100.0000, "estimated_amount": 12092, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 9673.68, "standard_charge_percentage": 80.0000, "estimated_amount": 9673, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 8464.47, "standard_charge_percentage": 70.0000, "estimated_amount": 8464, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 9915.52, "standard_charge_percentage": 82.0000, "estimated_amount": 9915, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 7255.26, "standard_charge_percentage": 60.0000, "estimated_amount": 7255, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Revasc Fem/Pop Art Angioplasty", "code_information": [ { "code": "37224", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18554, "discounted_cash": 6972,"minimum": 2031.33,"maximum": 18554,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 4860.44, "estimated_amount": 4860, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 7047.64, "estimated_amount": 7047, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 6950.43, "estimated_amount": 6950, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9277, "standard_charge_percentage": 50.0000, "estimated_amount": 9277, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5566.2, "standard_charge_percentage": 30.0000, "estimated_amount": 5566, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 15214.3, "standard_charge_percentage": 82.0000, "estimated_amount": 15214, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 10761.3, "standard_charge_percentage": 58.0000, "estimated_amount": 10761, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 11132.4, "standard_charge_percentage": 60.0000, "estimated_amount": 11132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 5631.71, "estimated_amount": 5631, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 5470.8, "estimated_amount": 5470, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 7508.94, "estimated_amount": 7508, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 4860.44, "estimated_amount": 4860, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 5228.96, "estimated_amount": 5228, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7421.6, "standard_charge_percentage": 40.0000, "estimated_amount": 7421, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 18554, "standard_charge_percentage": 100.0000, "estimated_amount": 18554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 18554, "standard_charge_percentage": 100.0000, "estimated_amount": 18554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10390.2, "standard_charge_percentage": 56.0000, "estimated_amount": 10390, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 5631.71, "estimated_amount": 5631, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9922.53, "estimated_amount": 9922, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 6999.03, "estimated_amount": 6999, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2031.33, "estimated_amount": 2031, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 16234.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 17626.3, "standard_charge_percentage": 95.0000, "estimated_amount": 17626, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 18182.9, "standard_charge_percentage": 98.0000, "estimated_amount": 18182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 7240.77, "estimated_amount": 7240, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 8581.65, "estimated_amount": 8581, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 8581.65, "estimated_amount": 8581, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 15770.9, "standard_charge_percentage": 85.0000, "estimated_amount": 15770, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 16234.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16234, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 11132.4, "standard_charge_percentage": 60.0000, "estimated_amount": 11132, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 6864.98, "standard_charge_percentage": 37.0000, "estimated_amount": 6864, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 7508.94, "estimated_amount": 7508, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 10727.1, "estimated_amount": 10727, "methodology": "fee schedule" }]}]} , { "description": "Hc Revasc Fem/Pop Art Angiopl/Atherectomy", "code_information": [ { "code": "37225", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 38348.3, "discounted_cash": 21959,"minimum": 4081,"maximum": 38348.3,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 22043.2, "estimated_amount": 22043, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4312.45, "estimated_amount": 4312, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 22196.3, "estimated_amount": 22196, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 33554.8, "standard_charge_percentage": 87.5000, "estimated_amount": 33554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 38348.3, "standard_charge_percentage": 100.0000, "estimated_amount": 38348, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 23009, "standard_charge_percentage": 60.0000, "estimated_amount": 23008, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 31250.6, "estimated_amount": 31250, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 27027.6, "estimated_amount": 27027, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 32596.1, "standard_charge_percentage": 85.0000, "estimated_amount": 32596, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 31445.6, "standard_charge_percentage": 82.0000, "estimated_amount": 31445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 23009, "standard_charge_percentage": 60.0000, "estimated_amount": 23008, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 38348.3, "estimated_amount": 38348, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 21890.1, "estimated_amount": 21890, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 19174.2, "standard_charge_percentage": 50.0000, "estimated_amount": 19174, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 33554.8, "standard_charge_percentage": 87.5000, "estimated_amount": 33554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 38348.3, "standard_charge_percentage": 100.0000, "estimated_amount": 38348, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11504.5, "standard_charge_percentage": 30.0000, "estimated_amount": 11504, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 21475, "standard_charge_percentage": 56.0000, "estimated_amount": 21475, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 14188.9, "standard_charge_percentage": 37.0000, "estimated_amount": 14188, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 37581.3, "standard_charge_percentage": 98.0000, "estimated_amount": 37581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 27027.6, "estimated_amount": 27027, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 15339.3, "standard_charge_percentage": 40.0000, "estimated_amount": 15339, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 36430.9, "standard_charge_percentage": 95.0000, "estimated_amount": 36430, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 22242, "standard_charge_percentage": 58.0000, "estimated_amount": 22242, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 23649.1, "estimated_amount": 23649, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 17230.1, "estimated_amount": 17230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 22804.5, "estimated_amount": 22804, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 23649.1, "estimated_amount": 23649, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 33784.5, "estimated_amount": 33784, "methodology": "fee schedule" }]}]} , { "description": "Hc Revasc Fem/Pop Art Angiopl/Stnt", "code_information": [ { "code": "37226", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 38348.3, "discounted_cash": 13868,"minimum": 4081,"maximum": 38348.3,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 19174.2, "standard_charge_percentage": 50.0000, "estimated_amount": 19174, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 32596.1, "standard_charge_percentage": 85.0000, "estimated_amount": 32596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11504.5, "standard_charge_percentage": 30.0000, "estimated_amount": 11504, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 31445.6, "standard_charge_percentage": 82.0000, "estimated_amount": 31445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 23009, "standard_charge_percentage": 60.0000, "estimated_amount": 23008, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 37775, "estimated_amount": 37775, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10881.7, "estimated_amount": 10881, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 13921.4, "estimated_amount": 13921, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4312.45, "estimated_amount": 4312, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 13824.7, "estimated_amount": 13824, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 36430.9, "standard_charge_percentage": 95.0000, "estimated_amount": 36430, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 23009, "standard_charge_percentage": 60.0000, "estimated_amount": 23008, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 21475, "standard_charge_percentage": 56.0000, "estimated_amount": 21475, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 15339.3, "standard_charge_percentage": 40.0000, "estimated_amount": 15339, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 22242, "standard_charge_percentage": 58.0000, "estimated_amount": 22242, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 14402.2, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 14018, "estimated_amount": 14018, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 33554.8, "standard_charge_percentage": 87.5000, "estimated_amount": 33554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 33554.8, "standard_charge_percentage": 87.5000, "estimated_amount": 33554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 38348.3, "standard_charge_percentage": 100.0000, "estimated_amount": 38348, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 38348.3, "standard_charge_percentage": 100.0000, "estimated_amount": 38348, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 14188.9, "standard_charge_percentage": 37.0000, "estimated_amount": 14188, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 37581.3, "standard_charge_percentage": 98.0000, "estimated_amount": 37581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 19736.3, "estimated_amount": 19736, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 21336.6, "estimated_amount": 21336, "methodology": "fee schedule" }]}]} , { "description": "Hc Revasc Fem/Pop Art Angiopl/Stnt/Atherectomy", "code_information": [ { "code": "37227", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 58452.4, "discounted_cash": 21959,"minimum": 4081,"maximum": 58452.4,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 21890.1, "estimated_amount": 21890, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 29226.2, "standard_charge_percentage": 50.0000, "estimated_amount": 29226, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 52607.2, "standard_charge_percentage": 90.0000, "estimated_amount": 52607, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 52607.2, "standard_charge_percentage": 90.0000, "estimated_amount": 52607, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 51145.8, "standard_charge_percentage": 87.5000, "estimated_amount": 51145, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 55529.8, "standard_charge_percentage": 95.0000, "estimated_amount": 55529, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 17535.7, "standard_charge_percentage": 30.0000, "estimated_amount": 17535, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 40916.7, "standard_charge_percentage": 70.0000, "estimated_amount": 40916, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 21627.4, "standard_charge_percentage": 37.0000, "estimated_amount": 21627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 52607.2, "standard_charge_percentage": 90.0000, "estimated_amount": 52607, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 43839.3, "standard_charge_percentage": 75.0000, "estimated_amount": 43839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 22804.5, "estimated_amount": 22804, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 27027.6, "estimated_amount": 27027, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 43839.3, "standard_charge_percentage": 75.0000, "estimated_amount": 43839, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 49684.5, "standard_charge_percentage": 85.0000, "estimated_amount": 49684, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 58452.4, "standard_charge_percentage": 100.0000, "estimated_amount": 58452, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 33902.4, "standard_charge_percentage": 58.0000, "estimated_amount": 33902, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 57283.3, "standard_charge_percentage": 98.0000, "estimated_amount": 57283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 35071.4, "standard_charge_percentage": 60.0000, "estimated_amount": 35071, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 23649.1, "estimated_amount": 23649, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 58452.4, "estimated_amount": 58452, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 22043.2, "estimated_amount": 22043, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 7468.62, "estimated_amount": 7468, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 22196.3, "estimated_amount": 22196, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 23381, "standard_charge_percentage": 40.0000, "estimated_amount": 23380, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 51145.8, "standard_charge_percentage": 87.5000, "estimated_amount": 51145, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 58452.4, "standard_charge_percentage": 100.0000, "estimated_amount": 58452, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 40916.7, "standard_charge_percentage": 70.0000, "estimated_amount": 40916, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 43839.3, "standard_charge_percentage": 75.0000, "estimated_amount": 43839, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 32733.3, "standard_charge_percentage": 56.0000, "estimated_amount": 32733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 17222.3, "estimated_amount": 17222, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 43839.3, "standard_charge_percentage": 75.0000, "estimated_amount": 43839, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 52607.2, "standard_charge_percentage": 90.0000, "estimated_amount": 52607, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 35071.4, "standard_charge_percentage": 60.0000, "estimated_amount": 35071, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 43839.3, "standard_charge_percentage": 75.0000, "estimated_amount": 43839, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 40916.7, "standard_charge_percentage": 70.0000, "estimated_amount": 40916, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 47931, "standard_charge_percentage": 82.0000, "estimated_amount": 47930, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 52607.2, "standard_charge_percentage": 90.0000, "estimated_amount": 52607, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 17230.1, "estimated_amount": 17230, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 23649.1, "estimated_amount": 23649, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 31250.6, "estimated_amount": 31250, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 27027.6, "estimated_amount": 27027, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 33784.5, "estimated_amount": 33784, "methodology": "fee schedule" }]}]} , { "description": "Hc Revasc Tibial/Peron Art Angiopl Init", "code_information": [ { "code": "37228", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 38348.3, "discounted_cash": 13868,"minimum": 2031.33,"maximum": 38348.3,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 19174.2, "standard_charge_percentage": 50.0000, "estimated_amount": 19174, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 38348.3, "standard_charge_percentage": 100.0000, "estimated_amount": 38348, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 31445.6, "standard_charge_percentage": 82.0000, "estimated_amount": 31445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 23009, "standard_charge_percentage": 60.0000, "estimated_amount": 23008, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 13921.4, "estimated_amount": 13921, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2031.33, "estimated_amount": 2031, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 13824.7, "estimated_amount": 13824, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 15339.3, "standard_charge_percentage": 40.0000, "estimated_amount": 15339, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 33554.8, "standard_charge_percentage": 87.5000, "estimated_amount": 33554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 38348.3, "standard_charge_percentage": 100.0000, "estimated_amount": 38348, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 23009, "standard_charge_percentage": 60.0000, "estimated_amount": 23008, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 21475, "standard_charge_percentage": 56.0000, "estimated_amount": 21475, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 14188.9, "standard_charge_percentage": 37.0000, "estimated_amount": 14188, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 37581.3, "standard_charge_percentage": 98.0000, "estimated_amount": 37581, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 19736.3, "estimated_amount": 19736, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 14018, "estimated_amount": 14018, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 33554.8, "standard_charge_percentage": 87.5000, "estimated_amount": 33554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11504.5, "standard_charge_percentage": 30.0000, "estimated_amount": 11504, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10881.7, "estimated_amount": 10881, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 21336.6, "estimated_amount": 21336, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 32596.1, "standard_charge_percentage": 85.0000, "estimated_amount": 32596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 36430.9, "standard_charge_percentage": 95.0000, "estimated_amount": 36430, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 22242, "standard_charge_percentage": 58.0000, "estimated_amount": 22242, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 37775, "estimated_amount": 37775, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 14402.2, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" }]}]} , { "description": "Hc Revasc Tibial/Peron Art Angiopl/Atherect Init", "code_information": [ { "code": "37229", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 58452.4, "discounted_cash": 21959,"minimum": 4081,"maximum": 58452.4,"payers_information":[{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 29226.2, "standard_charge_percentage": 50.0000, "estimated_amount": 29226, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 52607.2, "standard_charge_percentage": 90.0000, "estimated_amount": 52607, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 55529.8, "standard_charge_percentage": 95.0000, "estimated_amount": 55529, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 17535.7, "standard_charge_percentage": 30.0000, "estimated_amount": 17535, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 43839.3, "standard_charge_percentage": 75.0000, "estimated_amount": 43839, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 40916.7, "standard_charge_percentage": 70.0000, "estimated_amount": 40916, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 21627.4, "standard_charge_percentage": 37.0000, "estimated_amount": 21627, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 52607.2, "standard_charge_percentage": 90.0000, "estimated_amount": 52607, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 43839.3, "standard_charge_percentage": 75.0000, "estimated_amount": 43839, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 22804.5, "estimated_amount": 22804, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 27027.6, "estimated_amount": 27027, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 22043.2, "estimated_amount": 22043, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 21890.1, "estimated_amount": 21890, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 43839.3, "standard_charge_percentage": 75.0000, "estimated_amount": 43839, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 51145.8, "standard_charge_percentage": 87.5000, "estimated_amount": 51145, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 35071.4, "standard_charge_percentage": 60.0000, "estimated_amount": 35071, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 47931, "standard_charge_percentage": 82.0000, "estimated_amount": 47930, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 33902.4, "standard_charge_percentage": 58.0000, "estimated_amount": 33902, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 23649.1, "estimated_amount": 23649, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 58452.4, "estimated_amount": 58452, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 4312.45, "estimated_amount": 4312, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 22196.3, "estimated_amount": 22196, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 4081, "estimated_amount": 4081, "methodology": "case rate" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 49684.5, "standard_charge_percentage": 85.0000, "estimated_amount": 49684, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 23381, "standard_charge_percentage": 40.0000, "estimated_amount": 23380, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 51145.8, "standard_charge_percentage": 87.5000, "estimated_amount": 51145, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 58452.4, "standard_charge_percentage": 100.0000, "estimated_amount": 58452, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 40916.7, "standard_charge_percentage": 70.0000, "estimated_amount": 40916, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 43839.3, "standard_charge_percentage": 75.0000, "estimated_amount": 43839, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 32733.3, "standard_charge_percentage": 56.0000, "estimated_amount": 32733, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 35071.4, "standard_charge_percentage": 60.0000, "estimated_amount": 35071, "methodology": "percent of total billed charges" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 17222.3, "estimated_amount": 17222, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 43839.3, "standard_charge_percentage": 75.0000, "estimated_amount": 43839, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 52607.2, "standard_charge_percentage": 90.0000, "estimated_amount": 52607, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 52607.2, "standard_charge_percentage": 90.0000, "estimated_amount": 52607, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 58452.4, "standard_charge_percentage": 100.0000, "estimated_amount": 58452, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 46761.9, "standard_charge_percentage": 80.0000, "estimated_amount": 46761, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 40916.7, "standard_charge_percentage": 70.0000, "estimated_amount": 40916, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 52607.2, "standard_charge_percentage": 90.0000, "estimated_amount": 52607, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 57283.3, "standard_charge_percentage": 98.0000, "estimated_amount": 57283, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 17230.1, "estimated_amount": 17230, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 23649.1, "estimated_amount": 23649, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 31250.6, "estimated_amount": 31250, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 27027.6, "estimated_amount": 27027, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 33784.5, "estimated_amount": 33784, "methodology": "fee schedule" }]}]} , { "description": "Hc Revasc Tibial/Peron Art Angiopl/Stent Ea Add", "code_information": [ { "code": "37234", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 14594.5,"minimum": 1662,"maximum": 14594.5,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 13135, "standard_charge_percentage": 90.0000, "estimated_amount": 13135, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 11675.6, "standard_charge_percentage": 80.0000, "estimated_amount": 11675, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 11675.6, "standard_charge_percentage": 80.0000, "estimated_amount": 11675, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 8756.7, "standard_charge_percentage": 60.0000, "estimated_amount": 8756, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 11675.6, "standard_charge_percentage": 80.0000, "estimated_amount": 11675, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 11675.6, "standard_charge_percentage": 80.0000, "estimated_amount": 11675, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 10945.9, "standard_charge_percentage": 75.0000, "estimated_amount": 10945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 11675.6, "standard_charge_percentage": 80.0000, "estimated_amount": 11675, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 10945.9, "standard_charge_percentage": 75.0000, "estimated_amount": 10945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 8756.7, "standard_charge_percentage": 60.0000, "estimated_amount": 8756, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 13135, "standard_charge_percentage": 90.0000, "estimated_amount": 13135, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 13864.8, "standard_charge_percentage": 95.0000, "estimated_amount": 13864, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 11675.6, "standard_charge_percentage": 80.0000, "estimated_amount": 11675, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 10216.2, "standard_charge_percentage": 70.0000, "estimated_amount": 10216, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 10216.2, "standard_charge_percentage": 70.0000, "estimated_amount": 10216, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 10216.2, "standard_charge_percentage": 70.0000, "estimated_amount": 10216, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 11967.5, "standard_charge_percentage": 82.0000, "estimated_amount": 11967, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 12770.2, "standard_charge_percentage": 87.5000, "estimated_amount": 12770, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 14594.5, "standard_charge_percentage": 100.0000, "estimated_amount": 14594, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 14594.5, "standard_charge_percentage": 100.0000, "estimated_amount": 14594, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 11675.6, "standard_charge_percentage": 80.0000, "estimated_amount": 11675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 4378.35, "standard_charge_percentage": 30.0000, "estimated_amount": 4378, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 8172.92, "standard_charge_percentage": 56.0000, "estimated_amount": 8172, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 13135, "standard_charge_percentage": 90.0000, "estimated_amount": 13135, "methodology": "percent of total billed charges" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 2031.33, "estimated_amount": 2031, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 10945.9, "standard_charge_percentage": 75.0000, "estimated_amount": 10945, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 11675.6, "standard_charge_percentage": 80.0000, "estimated_amount": 11675, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 10945.9, "standard_charge_percentage": 75.0000, "estimated_amount": 10945, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 11675.6, "standard_charge_percentage": 80.0000, "estimated_amount": 11675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 7297.25, "standard_charge_percentage": 50.0000, "estimated_amount": 7297, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 13135, "standard_charge_percentage": 90.0000, "estimated_amount": 13135, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 12405.3, "standard_charge_percentage": 85.0000, "estimated_amount": 12405, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 5837.8, "standard_charge_percentage": 40.0000, "estimated_amount": 5837, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 12770.2, "standard_charge_percentage": 87.5000, "estimated_amount": 12770, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 11675.6, "standard_charge_percentage": 80.0000, "estimated_amount": 11675, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 10945.9, "standard_charge_percentage": 75.0000, "estimated_amount": 10945, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 8464.81, "standard_charge_percentage": 58.0000, "estimated_amount": 8464, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 5399.97, "standard_charge_percentage": 37.0000, "estimated_amount": 5399, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 13135, "standard_charge_percentage": 90.0000, "estimated_amount": 13135, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 14302.6, "standard_charge_percentage": 98.0000, "estimated_amount": 14302, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Open/Perq Placement Intravascular Stent Initial", "code_information": [ { "code": "37236", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 38348.3, "discounted_cash": 13868,"minimum": 3130,"maximum": 38348.3,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 6164.92, "estimated_amount": 6164, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 6164.92, "estimated_amount": 6164, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 14018, "estimated_amount": 14018, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 19174.2, "standard_charge_percentage": 50.0000, "estimated_amount": 19174, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 15339.3, "standard_charge_percentage": 40.0000, "estimated_amount": 15339, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 33554.8, "standard_charge_percentage": 87.5000, "estimated_amount": 33554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 11504.5, "standard_charge_percentage": 30.0000, "estimated_amount": 11504, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 14188.9, "standard_charge_percentage": 37.0000, "estimated_amount": 14188, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 37581.3, "standard_charge_percentage": 98.0000, "estimated_amount": 37581, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 19736.3, "estimated_amount": 19736, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 21336.6, "estimated_amount": 21336, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 13921.4, "estimated_amount": 13921, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 36430.9, "standard_charge_percentage": 95.0000, "estimated_amount": 36430, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 38348.3, "standard_charge_percentage": 100.0000, "estimated_amount": 38348, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 21475, "standard_charge_percentage": 56.0000, "estimated_amount": 21475, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 37775, "estimated_amount": 37775, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10881.7, "estimated_amount": 10881, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 13824.7, "estimated_amount": 13824, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 34513.5, "standard_charge_percentage": 90.0000, "estimated_amount": 34513, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 31445.6, "standard_charge_percentage": 82.0000, "estimated_amount": 31445, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 22242, "standard_charge_percentage": 58.0000, "estimated_amount": 22242, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 32596.1, "standard_charge_percentage": 85.0000, "estimated_amount": 32596, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 33554.8, "standard_charge_percentage": 87.5000, "estimated_amount": 33554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 38348.3, "standard_charge_percentage": 100.0000, "estimated_amount": 38348, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 23009, "standard_charge_percentage": 60.0000, "estimated_amount": 23008, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 26843.8, "standard_charge_percentage": 70.0000, "estimated_amount": 26843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 30678.6, "standard_charge_percentage": 80.0000, "estimated_amount": 30678, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 28761.2, "standard_charge_percentage": 75.0000, "estimated_amount": 28761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 23009, "standard_charge_percentage": 60.0000, "estimated_amount": 23008, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 14402.2, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" }]}]} , { "description": "Hc Open/Perq Placement Intravascular Stnt Same 1St", "code_information": [ { "code": "37238", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 35279.1, "discounted_cash": 13868,"minimum": 3130,"maximum": 35279.1,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 6164.92, "estimated_amount": 6164, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 6164.92, "estimated_amount": 6164, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 14018, "estimated_amount": 14018, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 33515.1, "standard_charge_percentage": 95.0000, "estimated_amount": 33515, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10583.7, "standard_charge_percentage": 30.0000, "estimated_amount": 10583, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 26459.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26459, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 19756.3, "standard_charge_percentage": 56.0000, "estimated_amount": 19756, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 20461.9, "standard_charge_percentage": 58.0000, "estimated_amount": 20461, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 34573.5, "standard_charge_percentage": 98.0000, "estimated_amount": 34573, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 26459.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26459, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 35279.1, "estimated_amount": 35279, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 14402.2, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 13921.4, "estimated_amount": 13921, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 14111.6, "standard_charge_percentage": 40.0000, "estimated_amount": 14111, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 30869.2, "standard_charge_percentage": 87.5000, "estimated_amount": 30869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 35279.1, "standard_charge_percentage": 100.0000, "estimated_amount": 35279, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 21167.5, "standard_charge_percentage": 60.0000, "estimated_amount": 21167, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 28928.9, "standard_charge_percentage": 82.0000, "estimated_amount": 28928, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 21167.5, "standard_charge_percentage": 60.0000, "estimated_amount": 21167, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 26459.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26459, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 26459.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26459, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 30869.2, "standard_charge_percentage": 87.5000, "estimated_amount": 30869, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 26459.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26459, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 13053.3, "standard_charge_percentage": 37.0000, "estimated_amount": 13053, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 31751.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10881.7, "estimated_amount": 10881, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 13824.7, "estimated_amount": 13824, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 17639.5, "standard_charge_percentage": 50.0000, "estimated_amount": 17639, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 31751.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31751, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 31751.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31751, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 31751.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31751, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 29987.2, "standard_charge_percentage": 85.0000, "estimated_amount": 29987, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 35279.1, "standard_charge_percentage": 100.0000, "estimated_amount": 35279, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 24695.4, "standard_charge_percentage": 70.0000, "estimated_amount": 24695, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 24695.4, "standard_charge_percentage": 70.0000, "estimated_amount": 24695, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 24695.4, "standard_charge_percentage": 70.0000, "estimated_amount": 24695, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 31751.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31751, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 19736.3, "estimated_amount": 19736, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 21336.6, "estimated_amount": 21336, "methodology": "fee schedule" }]}]} , { "description": "Hc Vascular Embolization Or Occlusion Venous Rs&I", "code_information": [ { "code": "37241", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 53981.3, "discounted_cash": 13868,"minimum": 3130,"maximum": 53981.3,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 13921.4, "estimated_amount": 13921, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 40486, "standard_charge_percentage": 75.0000, "estimated_amount": 40485, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 45884.1, "standard_charge_percentage": 85.0000, "estimated_amount": 45884, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 43185, "standard_charge_percentage": 80.0000, "estimated_amount": 43185, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 43185, "standard_charge_percentage": 80.0000, "estimated_amount": 43185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 16194.4, "standard_charge_percentage": 30.0000, "estimated_amount": 16194, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 37786.9, "standard_charge_percentage": 70.0000, "estimated_amount": 37786, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 32388.8, "standard_charge_percentage": 60.0000, "estimated_amount": 32388, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 37775, "estimated_amount": 37775, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10881.7, "estimated_amount": 10881, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 43185, "standard_charge_percentage": 80.0000, "estimated_amount": 43185, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 48583.2, "standard_charge_percentage": 90.0000, "estimated_amount": 48583, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 43185, "standard_charge_percentage": 80.0000, "estimated_amount": 43185, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 43185, "standard_charge_percentage": 80.0000, "estimated_amount": 43185, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 53981.3, "standard_charge_percentage": 100.0000, "estimated_amount": 53981, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 43185, "standard_charge_percentage": 80.0000, "estimated_amount": 43185, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 43185, "standard_charge_percentage": 80.0000, "estimated_amount": 43185, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 37786.9, "standard_charge_percentage": 70.0000, "estimated_amount": 37786, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 40486, "standard_charge_percentage": 75.0000, "estimated_amount": 40485, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 30229.5, "standard_charge_percentage": 56.0000, "estimated_amount": 30229, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 31309.2, "standard_charge_percentage": 58.0000, "estimated_amount": 31309, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 52901.7, "standard_charge_percentage": 98.0000, "estimated_amount": 52901, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 40486, "standard_charge_percentage": 75.0000, "estimated_amount": 40485, "methodology": "percent of total billed charges" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 19736.3, "estimated_amount": 19736, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 21336.6, "estimated_amount": 21336, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 13824.7, "estimated_amount": 13824, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 43185, "standard_charge_percentage": 80.0000, "estimated_amount": 43185, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 40486, "standard_charge_percentage": 75.0000, "estimated_amount": 40485, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 48583.2, "standard_charge_percentage": 90.0000, "estimated_amount": 48583, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 21592.5, "standard_charge_percentage": 40.0000, "estimated_amount": 21592, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 47233.6, "standard_charge_percentage": 87.5000, "estimated_amount": 47233, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 47233.6, "standard_charge_percentage": 87.5000, "estimated_amount": 47233, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 43185, "standard_charge_percentage": 80.0000, "estimated_amount": 43185, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 40486, "standard_charge_percentage": 75.0000, "estimated_amount": 40485, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 37786.9, "standard_charge_percentage": 70.0000, "estimated_amount": 37786, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 44264.7, "standard_charge_percentage": 82.0000, "estimated_amount": 44264, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 19973.1, "standard_charge_percentage": 37.0000, "estimated_amount": 19973, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 43185, "standard_charge_percentage": 80.0000, "estimated_amount": 43185, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 48583.2, "standard_charge_percentage": 90.0000, "estimated_amount": 48583, "methodology": "percent of total billed charges" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 5977.64, "estimated_amount": 5977, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 5977.64, "estimated_amount": 5977, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 14018, "estimated_amount": 14018, "methodology": "fee schedule" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 26990.7, "standard_charge_percentage": 50.0000, "estimated_amount": 26990, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 48583.2, "standard_charge_percentage": 90.0000, "estimated_amount": 48583, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 51282.2, "standard_charge_percentage": 95.0000, "estimated_amount": 51282, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 53981.3, "standard_charge_percentage": 100.0000, "estimated_amount": 53981, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 32388.8, "standard_charge_percentage": 60.0000, "estimated_amount": 32388, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 48583.2, "standard_charge_percentage": 90.0000, "estimated_amount": 48583, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 14402.2, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" }]}]} , { "description": "Hc Vascular Embolization Or Occlusion Arterial S&I", "code_information": [ { "code": "37242", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 86042.6, "discounted_cash": 21959,"minimum": 3130,"maximum": 86042.6,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 5977.64, "estimated_amount": 5977, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 5977.64, "estimated_amount": 5977, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 64531.9, "standard_charge_percentage": 75.0000, "estimated_amount": 64531, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 64531.9, "standard_charge_percentage": 75.0000, "estimated_amount": 64531, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 68834.1, "standard_charge_percentage": 80.0000, "estimated_amount": 68834, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 73136.2, "standard_charge_percentage": 85.0000, "estimated_amount": 73136, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 75287.3, "standard_charge_percentage": 87.5000, "estimated_amount": 75287, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 86042.6, "standard_charge_percentage": 100.0000, "estimated_amount": 86042, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 25812.8, "standard_charge_percentage": 30.0000, "estimated_amount": 25812, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 64531.9, "standard_charge_percentage": 75.0000, "estimated_amount": 64531, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 49904.7, "standard_charge_percentage": 58.0000, "estimated_amount": 49904, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 77438.3, "standard_charge_percentage": 90.0000, "estimated_amount": 77438, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 84321.8, "standard_charge_percentage": 98.0000, "estimated_amount": 84321, "methodology": "percent of total billed charges" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 27027.6, "estimated_amount": 27027, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 23649.1, "estimated_amount": 23649, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 33784.5, "estimated_amount": 33784, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 43021.3, "standard_charge_percentage": 50.0000, "estimated_amount": 43021, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 77438.3, "standard_charge_percentage": 90.0000, "estimated_amount": 77438, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 86042.6, "standard_charge_percentage": 100.0000, "estimated_amount": 86042, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 51625.6, "standard_charge_percentage": 60.0000, "estimated_amount": 51625, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 68834.1, "standard_charge_percentage": 80.0000, "estimated_amount": 68834, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 23649.1, "estimated_amount": 23649, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 59813.2, "estimated_amount": 59813, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 22804.5, "estimated_amount": 22804, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 31250.6, "estimated_amount": 31250, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 27027.6, "estimated_amount": 27027, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 77438.3, "standard_charge_percentage": 90.0000, "estimated_amount": 77438, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 77438.3, "standard_charge_percentage": 90.0000, "estimated_amount": 77438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 68834.1, "standard_charge_percentage": 80.0000, "estimated_amount": 68834, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 68834.1, "standard_charge_percentage": 80.0000, "estimated_amount": 68834, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 68834.1, "standard_charge_percentage": 80.0000, "estimated_amount": 68834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 64531.9, "standard_charge_percentage": 75.0000, "estimated_amount": 64531, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 60229.8, "standard_charge_percentage": 70.0000, "estimated_amount": 60229, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 60229.8, "standard_charge_percentage": 70.0000, "estimated_amount": 60229, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 70554.9, "standard_charge_percentage": 82.0000, "estimated_amount": 70554, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 48183.9, "standard_charge_percentage": 56.0000, "estimated_amount": 48183, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 68834.1, "standard_charge_percentage": 80.0000, "estimated_amount": 68834, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 77438.3, "standard_charge_percentage": 90.0000, "estimated_amount": 77438, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 17230.1, "estimated_amount": 17230, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 22043.2, "estimated_amount": 22043, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 15307.8, "estimated_amount": 15307, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 22196.3, "estimated_amount": 22196, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 21890.1, "estimated_amount": 21890, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 68834.1, "standard_charge_percentage": 80.0000, "estimated_amount": 68834, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 34417, "standard_charge_percentage": 40.0000, "estimated_amount": 34417, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 75287.3, "standard_charge_percentage": 87.5000, "estimated_amount": 75287, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 68834.1, "standard_charge_percentage": 80.0000, "estimated_amount": 68834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 68834.1, "standard_charge_percentage": 80.0000, "estimated_amount": 68834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 68834.1, "standard_charge_percentage": 80.0000, "estimated_amount": 68834, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 81740.5, "standard_charge_percentage": 95.0000, "estimated_amount": 81740, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 60229.8, "standard_charge_percentage": 70.0000, "estimated_amount": 60229, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 31835.8, "standard_charge_percentage": 37.0000, "estimated_amount": 31835, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 64531.9, "standard_charge_percentage": 75.0000, "estimated_amount": 64531, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 51625.6, "standard_charge_percentage": 60.0000, "estimated_amount": 51625, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 16892.2, "estimated_amount": 16892, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 17736.8, "estimated_amount": 17736, "methodology": "fee schedule" }]}]} , { "description": "Hc Vascular Embolize/Occlude Organ Tumor Infarct", "code_information": [ { "code": "37243", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 56702.8, "discounted_cash": 13868,"minimum": 3130,"maximum": 56702.8,"payers_information":[{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 42527.1, "standard_charge_percentage": 75.0000, "estimated_amount": 42527, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 51032.5, "standard_charge_percentage": 90.0000, "estimated_amount": 51032, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 48197.4, "standard_charge_percentage": 85.0000, "estimated_amount": 48197, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 45362.2, "standard_charge_percentage": 80.0000, "estimated_amount": 45362, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 56702.8, "standard_charge_percentage": 100.0000, "estimated_amount": 56702, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 45362.2, "standard_charge_percentage": 80.0000, "estimated_amount": 45362, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 45362.2, "standard_charge_percentage": 80.0000, "estimated_amount": 45362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 17010.8, "standard_charge_percentage": 30.0000, "estimated_amount": 17010, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 39692, "standard_charge_percentage": 70.0000, "estimated_amount": 39691, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 42527.1, "standard_charge_percentage": 75.0000, "estimated_amount": 42527, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 32887.6, "standard_charge_percentage": 58.0000, "estimated_amount": 32887, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 45362.2, "standard_charge_percentage": 80.0000, "estimated_amount": 45362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 5977.64, "estimated_amount": 5977, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 5977.64, "estimated_amount": 5977, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 14018, "estimated_amount": 14018, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 13824.7, "estimated_amount": 13824, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 45362.2, "standard_charge_percentage": 80.0000, "estimated_amount": 45362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 28351.4, "standard_charge_percentage": 50.0000, "estimated_amount": 28351, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 51032.5, "standard_charge_percentage": 90.0000, "estimated_amount": 51032, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 49614.9, "standard_charge_percentage": 87.5000, "estimated_amount": 49614, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 45362.2, "standard_charge_percentage": 80.0000, "estimated_amount": 45362, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 56702.8, "standard_charge_percentage": 100.0000, "estimated_amount": 56702, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 45362.2, "standard_charge_percentage": 80.0000, "estimated_amount": 45362, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 51032.5, "standard_charge_percentage": 90.0000, "estimated_amount": 51032, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 13921.4, "estimated_amount": 13921, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 45362.2, "standard_charge_percentage": 80.0000, "estimated_amount": 45362, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 42527.1, "standard_charge_percentage": 75.0000, "estimated_amount": 42527, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 22681.1, "standard_charge_percentage": 40.0000, "estimated_amount": 22681, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 49614.9, "standard_charge_percentage": 87.5000, "estimated_amount": 49614, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 53867.7, "standard_charge_percentage": 95.0000, "estimated_amount": 53867, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 20980, "standard_charge_percentage": 37.0000, "estimated_amount": 20980, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 55568.7, "standard_charge_percentage": 98.0000, "estimated_amount": 55568, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 34021.7, "standard_charge_percentage": 60.0000, "estimated_amount": 34021, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 37775, "estimated_amount": 37775, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 19736.3, "estimated_amount": 19736, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 21336.6, "estimated_amount": 21336, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 51032.5, "standard_charge_percentage": 90.0000, "estimated_amount": 51032, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 45362.2, "standard_charge_percentage": 80.0000, "estimated_amount": 45362, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 34021.7, "standard_charge_percentage": 60.0000, "estimated_amount": 34021, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 45362.2, "standard_charge_percentage": 80.0000, "estimated_amount": 45362, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 42527.1, "standard_charge_percentage": 75.0000, "estimated_amount": 42527, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 39692, "standard_charge_percentage": 70.0000, "estimated_amount": 39691, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 39692, "standard_charge_percentage": 70.0000, "estimated_amount": 39691, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 46496.3, "standard_charge_percentage": 82.0000, "estimated_amount": 46496, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 31753.6, "standard_charge_percentage": 56.0000, "estimated_amount": 31753, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 51032.5, "standard_charge_percentage": 90.0000, "estimated_amount": 51032, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 42527.1, "standard_charge_percentage": 75.0000, "estimated_amount": 42527, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10881.7, "estimated_amount": 10881, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 14402.2, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" }]}]} , { "description": "Hc Vascular Embolization Or Occlusion Hemorrhage", "code_information": [ { "code": "37244", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 35279.1, "discounted_cash": 13868,"minimum": 3130,"maximum": 35279.1,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 5977.64, "estimated_amount": 5977, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 10642.9, "estimated_amount": 10642, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 30869.2, "standard_charge_percentage": 87.5000, "estimated_amount": 30869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 33515.1, "standard_charge_percentage": 95.0000, "estimated_amount": 33515, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 10583.7, "standard_charge_percentage": 30.0000, "estimated_amount": 10583, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 26459.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26459, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 24695.4, "standard_charge_percentage": 70.0000, "estimated_amount": 24695, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 26459.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 19736.3, "estimated_amount": 19736, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 13824.7, "estimated_amount": 13824, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 26459.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26459, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 26459.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26459, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 31751.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31751, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 14111.6, "standard_charge_percentage": 40.0000, "estimated_amount": 14111, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 30869.2, "standard_charge_percentage": 87.5000, "estimated_amount": 30869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 35279.1, "standard_charge_percentage": 100.0000, "estimated_amount": 35279, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 21167.5, "standard_charge_percentage": 60.0000, "estimated_amount": 21167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 21167.5, "standard_charge_percentage": 60.0000, "estimated_amount": 21167, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 14402.2, "estimated_amount": 14402, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 14935.6, "estimated_amount": 14935, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 13921.4, "estimated_amount": 13921, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 9667.62, "estimated_amount": 9667, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 3130, "estimated_amount": 3130, "methodology": "case rate" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 17639.5, "standard_charge_percentage": 50.0000, "estimated_amount": 17639, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 31751.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31751, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 31751.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31751, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 29987.2, "standard_charge_percentage": 85.0000, "estimated_amount": 29987, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 24695.4, "standard_charge_percentage": 70.0000, "estimated_amount": 24695, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 24695.4, "standard_charge_percentage": 70.0000, "estimated_amount": 24695, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 31751.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31751, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 26459.3, "standard_charge_percentage": 75.0000, "estimated_amount": 26459, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 35279.1, "estimated_amount": 35279, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 10881.7, "estimated_amount": 10881, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 17069.3, "estimated_amount": 17069, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 21336.6, "estimated_amount": 21336, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 5977.64, "estimated_amount": 5977, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 14018, "estimated_amount": 14018, "methodology": "fee schedule" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 35279.1, "standard_charge_percentage": 100.0000, "estimated_amount": 35279, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 28223.3, "standard_charge_percentage": 80.0000, "estimated_amount": 28223, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 28928.9, "standard_charge_percentage": 82.0000, "estimated_amount": 28928, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 19756.3, "standard_charge_percentage": 56.0000, "estimated_amount": 19756, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 20461.9, "standard_charge_percentage": 58.0000, "estimated_amount": 20461, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 13053.3, "standard_charge_percentage": 37.0000, "estimated_amount": 13053, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 31751.2, "standard_charge_percentage": 90.0000, "estimated_amount": 31751, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 34573.5, "standard_charge_percentage": 98.0000, "estimated_amount": 34573, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 11201.7, "estimated_amount": 11201, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 10668.3, "estimated_amount": 10668, "methodology": "fee schedule" }]}]} , { "description": "Hc Trlml Blln Angiop Open/Perq Img S&I Init Art", "code_information": [ { "code": "37246", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18554, "discounted_cash": 6972,"minimum": 3261.84,"maximum": 18554,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 6999.03, "estimated_amount": 6999, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 3261.84, "estimated_amount": 3261, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 5228.96, "estimated_amount": 5228, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 18554, "standard_charge_percentage": 100.0000, "estimated_amount": 18554, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 17626.3, "standard_charge_percentage": 95.0000, "estimated_amount": 17626, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 18554, "standard_charge_percentage": 100.0000, "estimated_amount": 18554, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10390.2, "standard_charge_percentage": 56.0000, "estimated_amount": 10390, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 6864.98, "standard_charge_percentage": 37.0000, "estimated_amount": 6864, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 7508.94, "estimated_amount": 7508, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 5631.71, "estimated_amount": 5631, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 7508.94, "estimated_amount": 7508, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 8581.65, "estimated_amount": 8581, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 3588.02, "estimated_amount": 3588, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9277, "standard_charge_percentage": 50.0000, "estimated_amount": 9277, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 16234.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 11132.4, "standard_charge_percentage": 60.0000, "estimated_amount": 11132, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 7240.77, "estimated_amount": 7240, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 10727.1, "estimated_amount": 10727, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 4860.44, "estimated_amount": 4860, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 7047.64, "estimated_amount": 7047, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 6950.43, "estimated_amount": 6950, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7421.6, "standard_charge_percentage": 40.0000, "estimated_amount": 7421, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 16234.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 15214.3, "standard_charge_percentage": 82.0000, "estimated_amount": 15214, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 18182.9, "standard_charge_percentage": 98.0000, "estimated_amount": 18182, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 5470.8, "estimated_amount": 5470, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 8581.65, "estimated_amount": 8581, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 5631.71, "estimated_amount": 5631, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9922.53, "estimated_amount": 9922, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 4860.44, "estimated_amount": 4860, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5151, "estimated_amount": 5151, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 15770.9, "standard_charge_percentage": 85.0000, "estimated_amount": 15770, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 11132.4, "standard_charge_percentage": 60.0000, "estimated_amount": 11132, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5566.2, "standard_charge_percentage": 30.0000, "estimated_amount": 5566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 10761.3, "standard_charge_percentage": 58.0000, "estimated_amount": 10761, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" }]}]} , { "description": "Hc Trlml Blln Angiop Open/Perq W/Img S&I Init Vein", "code_information": [ { "code": "37248", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 18554, "discounted_cash": 6972,"minimum": 3261.84,"maximum": 18554,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 9277, "standard_charge_percentage": 50.0000, "estimated_amount": 9277, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 16234.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 11132.4, "standard_charge_percentage": 60.0000, "estimated_amount": 11132, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 18182.9, "standard_charge_percentage": 98.0000, "estimated_amount": 18182, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 7508.94, "estimated_amount": 7508, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 5631.71, "estimated_amount": 5631, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 7508.94, "estimated_amount": 7508, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 8581.65, "estimated_amount": 8581, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 6999.03, "estimated_amount": 6999, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 3261.84, "estimated_amount": 3261, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 16234.8, "standard_charge_percentage": 87.5000, "estimated_amount": 16234, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 17626.3, "standard_charge_percentage": 95.0000, "estimated_amount": 17626, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 18554, "standard_charge_percentage": 100.0000, "estimated_amount": 18554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 6864.98, "standard_charge_percentage": 37.0000, "estimated_amount": 6864, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 7240.77, "estimated_amount": 7240, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 10727.1, "estimated_amount": 10727, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 4860.44, "estimated_amount": 4860, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 5228.96, "estimated_amount": 5228, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 3588.02, "estimated_amount": 3588, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 5151, "estimated_amount": 5151, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 15770.9, "standard_charge_percentage": 85.0000, "estimated_amount": 15770, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 18554, "standard_charge_percentage": 100.0000, "estimated_amount": 18554, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 5566.2, "standard_charge_percentage": 30.0000, "estimated_amount": 5566, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 10761.3, "standard_charge_percentage": 58.0000, "estimated_amount": 10761, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 14843.2, "standard_charge_percentage": 80.0000, "estimated_amount": 14843, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 5470.8, "estimated_amount": 5470, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 8581.65, "estimated_amount": 8581, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 5631.71, "estimated_amount": 5631, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 9922.53, "estimated_amount": 9922, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 4860.44, "estimated_amount": 4860, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 7047.64, "estimated_amount": 7047, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 6950.43, "estimated_amount": 6950, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 7421.6, "standard_charge_percentage": 40.0000, "estimated_amount": 7421, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 12987.8, "standard_charge_percentage": 70.0000, "estimated_amount": 12987, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 15214.3, "standard_charge_percentage": 82.0000, "estimated_amount": 15214, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 10390.2, "standard_charge_percentage": 56.0000, "estimated_amount": 10390, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 16698.6, "standard_charge_percentage": 90.0000, "estimated_amount": 16698, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 13915.5, "standard_charge_percentage": 75.0000, "estimated_amount": 13915, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 11132.4, "standard_charge_percentage": 60.0000, "estimated_amount": 11132, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 18554, "estimated_amount": 18554, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 5363.53, "estimated_amount": 5363, "methodology": "fee schedule" }]}]} , { "description": "Hc Trlml Blln Angiop Open/Perq W/Img S&I Addl Vein", "code_information": [ { "code": "37249", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5927.28,"minimum": 98.88,"maximum": 5927.28,"payers_information":[{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2370.91, "standard_charge_percentage": 40.0000, "estimated_amount": 2370, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5927.28, "standard_charge_percentage": 100.0000, "estimated_amount": 5927, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4741.82, "standard_charge_percentage": 80.0000, "estimated_amount": 4741, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4741.82, "standard_charge_percentage": 80.0000, "estimated_amount": 4741, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4149.1, "standard_charge_percentage": 70.0000, "estimated_amount": 4149, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4860.37, "standard_charge_percentage": 82.0000, "estimated_amount": 4860, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3437.82, "standard_charge_percentage": 58.0000, "estimated_amount": 3437, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2193.09, "standard_charge_percentage": 37.0000, "estimated_amount": 2193, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5808.73, "standard_charge_percentage": 98.0000, "estimated_amount": 5808, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5334.55, "standard_charge_percentage": 90.0000, "estimated_amount": 5334, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4741.82, "standard_charge_percentage": 80.0000, "estimated_amount": 4741, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4741.82, "standard_charge_percentage": 80.0000, "estimated_amount": 4741, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1778.18, "standard_charge_percentage": 30.0000, "estimated_amount": 1778, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4149.1, "standard_charge_percentage": 70.0000, "estimated_amount": 4149, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4149.1, "standard_charge_percentage": 70.0000, "estimated_amount": 4149, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4741.82, "standard_charge_percentage": 80.0000, "estimated_amount": 4741, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4445.46, "standard_charge_percentage": 75.0000, "estimated_amount": 4445, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5334.55, "standard_charge_percentage": 90.0000, "estimated_amount": 5334, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5186.37, "standard_charge_percentage": 87.5000, "estimated_amount": 5186, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4741.82, "standard_charge_percentage": 80.0000, "estimated_amount": 4741, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5630.92, "standard_charge_percentage": 95.0000, "estimated_amount": 5630, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4445.46, "standard_charge_percentage": 75.0000, "estimated_amount": 4445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3556.37, "standard_charge_percentage": 60.0000, "estimated_amount": 3556, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 98.88, "estimated_amount": 98, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4741.82, "standard_charge_percentage": 80.0000, "estimated_amount": 4741, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4445.46, "standard_charge_percentage": 75.0000, "estimated_amount": 4445, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4741.82, "standard_charge_percentage": 80.0000, "estimated_amount": 4741, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2963.64, "standard_charge_percentage": 50.0000, "estimated_amount": 2963, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5334.55, "standard_charge_percentage": 90.0000, "estimated_amount": 5334, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5038.19, "standard_charge_percentage": 85.0000, "estimated_amount": 5038, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5186.37, "standard_charge_percentage": 87.5000, "estimated_amount": 5186, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4741.82, "standard_charge_percentage": 80.0000, "estimated_amount": 4741, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5927.28, "standard_charge_percentage": 100.0000, "estimated_amount": 5927, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3556.37, "standard_charge_percentage": 60.0000, "estimated_amount": 3556, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4741.82, "standard_charge_percentage": 80.0000, "estimated_amount": 4741, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4445.46, "standard_charge_percentage": 75.0000, "estimated_amount": 4445, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4445.46, "standard_charge_percentage": 75.0000, "estimated_amount": 4445, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3319.28, "standard_charge_percentage": 56.0000, "estimated_amount": 3319, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5334.55, "standard_charge_percentage": 90.0000, "estimated_amount": 5334, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5334.55, "standard_charge_percentage": 90.0000, "estimated_amount": 5334, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Intrvasc Us During Dx Eval/Interven W Img Init Vssl", "code_information": [ { "code": "37252", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6439.3,"minimum": 1662,"maximum": 6439.3,"payers_information":[{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4829.48, "standard_charge_percentage": 75.0000, "estimated_amount": 4829, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 5151.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5151, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5473.4, "standard_charge_percentage": 85.0000, "estimated_amount": 5473, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 6439.3, "standard_charge_percentage": 100.0000, "estimated_amount": 6439, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3863.58, "standard_charge_percentage": 60.0000, "estimated_amount": 3863, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4507.51, "standard_charge_percentage": 70.0000, "estimated_amount": 4507, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3734.79, "standard_charge_percentage": 58.0000, "estimated_amount": 3734, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 5151.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5151, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5795.37, "standard_charge_percentage": 90.0000, "estimated_amount": 5795, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5634.39, "standard_charge_percentage": 87.5000, "estimated_amount": 5634, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 5151.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5151, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 6117.34, "standard_charge_percentage": 95.0000, "estimated_amount": 6117, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 5151.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5151, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4829.48, "standard_charge_percentage": 75.0000, "estimated_amount": 4829, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 5280.23, "standard_charge_percentage": 82.0000, "estimated_amount": 5280, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5795.37, "standard_charge_percentage": 90.0000, "estimated_amount": 5795, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4829.48, "standard_charge_percentage": 75.0000, "estimated_amount": 4829, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2575.72, "standard_charge_percentage": 40.0000, "estimated_amount": 2575, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 5151.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5151, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 6439.3, "standard_charge_percentage": 100.0000, "estimated_amount": 6439, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 5151.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5151, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4507.51, "standard_charge_percentage": 70.0000, "estimated_amount": 4507, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2382.54, "standard_charge_percentage": 37.0000, "estimated_amount": 2382, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 6310.51, "standard_charge_percentage": 98.0000, "estimated_amount": 6310, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 5151.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3219.65, "standard_charge_percentage": 50.0000, "estimated_amount": 3219, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5795.37, "standard_charge_percentage": 90.0000, "estimated_amount": 5795, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5795.37, "standard_charge_percentage": 90.0000, "estimated_amount": 5795, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5634.39, "standard_charge_percentage": 87.5000, "estimated_amount": 5634, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 5151.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 5151.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5151, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 5151.44, "standard_charge_percentage": 80.0000, "estimated_amount": 5151, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1931.79, "standard_charge_percentage": 30.0000, "estimated_amount": 1931, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4829.48, "standard_charge_percentage": 75.0000, "estimated_amount": 4829, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4507.51, "standard_charge_percentage": 70.0000, "estimated_amount": 4507, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3606.01, "standard_charge_percentage": 56.0000, "estimated_amount": 3606, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5795.37, "standard_charge_percentage": 90.0000, "estimated_amount": 5795, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4829.48, "standard_charge_percentage": 75.0000, "estimated_amount": 4829, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3863.58, "standard_charge_percentage": 60.0000, "estimated_amount": 3863, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Intrvasc Us During Dx Eval/Interven W Img Ea Add Vssl", "code_information": [ { "code": "37253", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 3877.59,"minimum": 1163.28,"maximum": 3877.59,"payers_information":[{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 3489.83, "standard_charge_percentage": 90.0000, "estimated_amount": 3489, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 3102.07, "standard_charge_percentage": 80.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 3102.07, "standard_charge_percentage": 80.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 3489.83, "standard_charge_percentage": 90.0000, "estimated_amount": 3489, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 3102.07, "standard_charge_percentage": 80.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 2908.19, "standard_charge_percentage": 75.0000, "estimated_amount": 2908, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 3683.71, "standard_charge_percentage": 95.0000, "estimated_amount": 3683, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 3102.07, "standard_charge_percentage": 80.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1163.28, "standard_charge_percentage": 30.0000, "estimated_amount": 1163, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 2714.31, "standard_charge_percentage": 70.0000, "estimated_amount": 2714, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2249, "standard_charge_percentage": 58.0000, "estimated_amount": 2249, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 3489.83, "standard_charge_percentage": 90.0000, "estimated_amount": 3489, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 2326.55, "standard_charge_percentage": 60.0000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 2908.19, "standard_charge_percentage": 75.0000, "estimated_amount": 2908, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 1938.8, "standard_charge_percentage": 50.0000, "estimated_amount": 1938, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 3489.83, "standard_charge_percentage": 90.0000, "estimated_amount": 3489, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 3489.83, "standard_charge_percentage": 90.0000, "estimated_amount": 3489, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 3295.95, "standard_charge_percentage": 85.0000, "estimated_amount": 3295, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 1551.04, "standard_charge_percentage": 40.0000, "estimated_amount": 1551, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 3392.89, "standard_charge_percentage": 87.5000, "estimated_amount": 3392, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 3392.89, "standard_charge_percentage": 87.5000, "estimated_amount": 3392, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 3102.07, "standard_charge_percentage": 80.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 3877.59, "standard_charge_percentage": 100.0000, "estimated_amount": 3877, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 2714.31, "standard_charge_percentage": 70.0000, "estimated_amount": 2714, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 2908.19, "standard_charge_percentage": 75.0000, "estimated_amount": 2908, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1434.71, "standard_charge_percentage": 37.0000, "estimated_amount": 1434, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 3102.07, "standard_charge_percentage": 80.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 3800.04, "standard_charge_percentage": 98.0000, "estimated_amount": 3800, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 3102.07, "standard_charge_percentage": 80.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 3102.07, "standard_charge_percentage": 80.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 3877.59, "standard_charge_percentage": 100.0000, "estimated_amount": 3877, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 2326.55, "standard_charge_percentage": 60.0000, "estimated_amount": 2326, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 3102.07, "standard_charge_percentage": 80.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 3102.07, "standard_charge_percentage": 80.0000, "estimated_amount": 3102, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 2908.19, "standard_charge_percentage": 75.0000, "estimated_amount": 2908, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 2714.31, "standard_charge_percentage": 70.0000, "estimated_amount": 2714, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 3179.62, "standard_charge_percentage": 82.0000, "estimated_amount": 3179, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2171.45, "standard_charge_percentage": 56.0000, "estimated_amount": 2171, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 2908.19, "standard_charge_percentage": 75.0000, "estimated_amount": 2908, "methodology": "percent of total billed charges" }]}]} , { "description": "Hc Bone Marrow; Aspiration Only", "code_information": [ { "code": "38220", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7851.2, "discounted_cash": 1981,"minimum": 525.22,"maximum": 7851.2,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6869.8, "standard_charge_percentage": 87.5000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7851.2, "standard_charge_percentage": 100.0000, "estimated_amount": 7851, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7851.2, "standard_charge_percentage": 100.0000, "estimated_amount": 7851, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2355.36, "standard_charge_percentage": 30.0000, "estimated_amount": 2355, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6869.8, "standard_charge_percentage": 87.5000, "estimated_amount": 6869, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6437.98, "standard_charge_percentage": 82.0000, "estimated_amount": 6437, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4553.7, "standard_charge_percentage": 58.0000, "estimated_amount": 4553, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3140.48, "standard_charge_percentage": 40.0000, "estimated_amount": 3140, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7458.64, "standard_charge_percentage": 95.0000, "estimated_amount": 7458, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4710.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4710, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5495.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5495, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5495.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5495, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5888.4, "standard_charge_percentage": 75.0000, "estimated_amount": 5888, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3925.6, "standard_charge_percentage": 50.0000, "estimated_amount": 3925, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6673.52, "standard_charge_percentage": 85.0000, "estimated_amount": 6673, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6280.96, "standard_charge_percentage": 80.0000, "estimated_amount": 6280, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5495.84, "standard_charge_percentage": 70.0000, "estimated_amount": 5495, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4396.67, "standard_charge_percentage": 56.0000, "estimated_amount": 4396, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2904.94, "standard_charge_percentage": 37.0000, "estimated_amount": 2904, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 7066.08, "standard_charge_percentage": 90.0000, "estimated_amount": 7066, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7694.18, "standard_charge_percentage": 98.0000, "estimated_amount": 7694, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4710.72, "standard_charge_percentage": 60.0000, "estimated_amount": 4710, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "Hc Bone Marrow Bx, Needle/Trocar", "code_information": [ { "code": "38221", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 6217.56, "discounted_cash": 1981,"minimum": 525.22,"maximum": 6217.56,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5595.8, "standard_charge_percentage": 90.0000, "estimated_amount": 5595, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5440.36, "standard_charge_percentage": 87.5000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4974.05, "standard_charge_percentage": 80.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4974.05, "standard_charge_percentage": 80.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5906.68, "standard_charge_percentage": 95.0000, "estimated_amount": 5906, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 6217.56, "standard_charge_percentage": 100.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4974.05, "standard_charge_percentage": 80.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4974.05, "standard_charge_percentage": 80.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4352.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4352, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5595.8, "standard_charge_percentage": 90.0000, "estimated_amount": 5595, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4663.17, "standard_charge_percentage": 75.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3730.54, "standard_charge_percentage": 60.0000, "estimated_amount": 3730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4974.05, "standard_charge_percentage": 80.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4974.05, "standard_charge_percentage": 80.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4974.05, "standard_charge_percentage": 80.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4663.17, "standard_charge_percentage": 75.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4352.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4352, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4663.17, "standard_charge_percentage": 75.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3481.83, "standard_charge_percentage": 56.0000, "estimated_amount": 3481, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4974.05, "standard_charge_percentage": 80.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5595.8, "standard_charge_percentage": 90.0000, "estimated_amount": 5595, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2487.02, "standard_charge_percentage": 40.0000, "estimated_amount": 2487, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3730.54, "standard_charge_percentage": 60.0000, "estimated_amount": 3730, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4974.05, "standard_charge_percentage": 80.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4663.17, "standard_charge_percentage": 75.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4663.17, "standard_charge_percentage": 75.0000, "estimated_amount": 4663, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3108.78, "standard_charge_percentage": 50.0000, "estimated_amount": 3108, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5595.8, "standard_charge_percentage": 90.0000, "estimated_amount": 5595, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5595.8, "standard_charge_percentage": 90.0000, "estimated_amount": 5595, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5284.93, "standard_charge_percentage": 85.0000, "estimated_amount": 5284, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5440.36, "standard_charge_percentage": 87.5000, "estimated_amount": 5440, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 6217.56, "standard_charge_percentage": 100.0000, "estimated_amount": 6217, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4974.05, "standard_charge_percentage": 80.0000, "estimated_amount": 4974, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1865.27, "standard_charge_percentage": 30.0000, "estimated_amount": 1865, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4352.29, "standard_charge_percentage": 70.0000, "estimated_amount": 4352, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 5098.4, "standard_charge_percentage": 82.0000, "estimated_amount": 5098, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3606.18, "standard_charge_percentage": 58.0000, "estimated_amount": 3606, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2300.5, "standard_charge_percentage": 37.0000, "estimated_amount": 2300, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 6093.21, "standard_charge_percentage": 98.0000, "estimated_amount": 6093, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" }]}]} , { "description": "Hc Diagnostic Bone Marrow Biopsies & Aspirations", "code_information": [ { "code": "38222", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5019.72, "discounted_cash": 3500,"minimum": 911.27,"maximum": 5019.72,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 911.27, "estimated_amount": 911, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 3764.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2509.86, "standard_charge_percentage": 50.0000, "estimated_amount": 2509, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5019.72, "standard_charge_percentage": 100.0000, "estimated_amount": 5019, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 4768.73, "standard_charge_percentage": 95.0000, "estimated_amount": 4768, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3513.8, "standard_charge_percentage": 70.0000, "estimated_amount": 3513, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 4517.75, "standard_charge_percentage": 90.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 4919.33, "standard_charge_percentage": 98.0000, "estimated_amount": 4919, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 3634.71, "estimated_amount": 3634, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 3764.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 4517.75, "standard_charge_percentage": 90.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 4517.75, "standard_charge_percentage": 90.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 4392.26, "standard_charge_percentage": 87.5000, "estimated_amount": 4392, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5019.72, "standard_charge_percentage": 100.0000, "estimated_amount": 5019, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3011.83, "standard_charge_percentage": 60.0000, "estimated_amount": 3011, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4116.17, "standard_charge_percentage": 82.0000, "estimated_amount": 4116, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 1857.3, "standard_charge_percentage": 37.0000, "estimated_amount": 1857, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 3764.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3764, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3011.83, "standard_charge_percentage": 60.0000, "estimated_amount": 3011, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 4307.81, "estimated_amount": 4307, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5019.72, "estimated_amount": 5019, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 2589.97, "estimated_amount": 2589, "methodology": "case rate" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 2439.84, "estimated_amount": 2439, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2007.89, "standard_charge_percentage": 40.0000, "estimated_amount": 2007, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 4392.26, "standard_charge_percentage": 87.5000, "estimated_amount": 4392, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1505.92, "standard_charge_percentage": 30.0000, "estimated_amount": 1505, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3513.8, "standard_charge_percentage": 70.0000, "estimated_amount": 3513, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3513.8, "standard_charge_percentage": 70.0000, "estimated_amount": 3513, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 2811.04, "standard_charge_percentage": 56.0000, "estimated_amount": 2811, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 4517.75, "standard_charge_percentage": 90.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5019.72, "estimated_amount": 5019, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 2746.23, "estimated_amount": 2746, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 4980.9, "estimated_amount": 4980, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 3513.37, "estimated_amount": 3513, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 911.27, "estimated_amount": 911, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 3537.77, "estimated_amount": 3537, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 3488.97, "estimated_amount": 3488, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 4517.75, "standard_charge_percentage": 90.0000, "estimated_amount": 4517, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4266.76, "standard_charge_percentage": 85.0000, "estimated_amount": 4266, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4015.78, "standard_charge_percentage": 80.0000, "estimated_amount": 4015, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 3764.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3764, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 3764.79, "standard_charge_percentage": 75.0000, "estimated_amount": 3764, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 2911.44, "standard_charge_percentage": 58.0000, "estimated_amount": 2911, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 2827, "estimated_amount": 2827, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 3769.33, "estimated_amount": 3769, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 2692.38, "estimated_amount": 2692, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "38500", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5891.43, "discounted_cash": 4682,"minimum": 898,"maximum": 5891.43,"payers_information":[{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1234.81, "estimated_amount": 1234, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 3264.39, "estimated_amount": 3264, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4668.08, "estimated_amount": 4668, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5302.29, "standard_charge_percentage": 90.0000, "estimated_amount": 5302, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 5155, "standard_charge_percentage": 87.5000, "estimated_amount": 5155, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5596.86, "standard_charge_percentage": 95.0000, "estimated_amount": 5596, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3534.86, "standard_charge_percentage": 60.0000, "estimated_amount": 3534, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4418.57, "standard_charge_percentage": 75.0000, "estimated_amount": 4418, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 4124, "standard_charge_percentage": 70.0000, "estimated_amount": 4124, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5302.29, "standard_charge_percentage": 90.0000, "estimated_amount": 5302, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5773.6, "standard_charge_percentage": 98.0000, "estimated_amount": 5773, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3534.86, "standard_charge_percentage": 60.0000, "estimated_amount": 3534, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 5043.19, "estimated_amount": 5043, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3782.39, "estimated_amount": 3782, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4863.08, "estimated_amount": 4863, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3782.39, "estimated_amount": 3782, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4700.72, "estimated_amount": 4700, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 3264.39, "estimated_amount": 3264, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 3446.73, "estimated_amount": 3446, "methodology": "case rate" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4733.37, "estimated_amount": 4733, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4418.57, "standard_charge_percentage": 75.0000, "estimated_amount": 4418, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2945.72, "standard_charge_percentage": 50.0000, "estimated_amount": 2945, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5302.29, "standard_charge_percentage": 90.0000, "estimated_amount": 5302, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5302.29, "standard_charge_percentage": 90.0000, "estimated_amount": 5302, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 4124, "standard_charge_percentage": 70.0000, "estimated_amount": 4124, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 4124, "standard_charge_percentage": 70.0000, "estimated_amount": 4124, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4830.97, "standard_charge_percentage": 82.0000, "estimated_amount": 4830, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3299.2, "standard_charge_percentage": 56.0000, "estimated_amount": 3299, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5302.29, "standard_charge_percentage": 90.0000, "estimated_amount": 5302, "methodology": "percent of total billed charges" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5891.43, "estimated_amount": 5891, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4418.57, "standard_charge_percentage": 75.0000, "estimated_amount": 4418, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2356.57, "standard_charge_percentage": 40.0000, "estimated_amount": 2356, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5891.43, "standard_charge_percentage": 100.0000, "estimated_amount": 5891, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4418.57, "standard_charge_percentage": 75.0000, "estimated_amount": 4418, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3417.03, "standard_charge_percentage": 58.0000, "estimated_amount": 3417, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 5763.65, "estimated_amount": 5763, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5891.43, "estimated_amount": 5891, "methodology": "fee schedule" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 5007.72, "standard_charge_percentage": 85.0000, "estimated_amount": 5007, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 5155, "standard_charge_percentage": 87.5000, "estimated_amount": 5155, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5891.43, "standard_charge_percentage": 100.0000, "estimated_amount": 5891, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1767.43, "standard_charge_percentage": 30.0000, "estimated_amount": 1767, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4713.14, "standard_charge_percentage": 80.0000, "estimated_amount": 4713, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4418.57, "standard_charge_percentage": 75.0000, "estimated_amount": 4418, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5891.43, "estimated_amount": 5891, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3674.33, "estimated_amount": 3674, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 5763.65, "estimated_amount": 5763, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 5043.19, "estimated_amount": 5043, "methodology": "fee schedule" }]}]} , { "description": "Hc Needle Biopsy, Lymph Node(S)", "code_information": [ { "code": "38505", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 7520.97, "discounted_cash": 1981,"minimum": 525.22,"maximum": 7520.97,"payers_information":[{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 4512.58, "standard_charge_percentage": 60.0000, "estimated_amount": 4512, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 4512.58, "standard_charge_percentage": 60.0000, "estimated_amount": 4512, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 1554.67, "estimated_amount": 1554, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 1381.22, "estimated_amount": 1381, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 1503.45, "estimated_amount": 1503, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 525.22, "estimated_amount": 525, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 1975.14, "estimated_amount": 1975, "methodology": "fee schedule" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 6392.82, "standard_charge_percentage": 85.0000, "estimated_amount": 6392, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 3008.39, "standard_charge_percentage": 40.0000, "estimated_amount": 3008, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 6580.85, "standard_charge_percentage": 87.5000, "estimated_amount": 6580, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 7520.97, "standard_charge_percentage": 100.0000, "estimated_amount": 7520, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 2782.76, "standard_charge_percentage": 37.0000, "estimated_amount": 2782, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 2133.87, "estimated_amount": 2133, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 3048.38, "estimated_amount": 3048, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 3760.49, "standard_charge_percentage": 50.0000, "estimated_amount": 3760, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 6580.85, "standard_charge_percentage": 87.5000, "estimated_amount": 6580, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 7520.97, "standard_charge_percentage": 100.0000, "estimated_amount": 7520, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2256.29, "standard_charge_percentage": 30.0000, "estimated_amount": 2256, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 6167.2, "standard_charge_percentage": 82.0000, "estimated_amount": 6167, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5396.95, "estimated_amount": 5396, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 2057.66, "estimated_amount": 2057, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 1600.4, "estimated_amount": 1600, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 2438.7, "estimated_amount": 2438, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 1988.96, "estimated_amount": 1988, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 2002.77, "estimated_amount": 2002, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 1662, "estimated_amount": 1662, "methodology": "case rate" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 7144.92, "standard_charge_percentage": 95.0000, "estimated_amount": 7144, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 6016.78, "standard_charge_percentage": 80.0000, "estimated_amount": 6016, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 5264.68, "standard_charge_percentage": 70.0000, "estimated_amount": 5264, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 4211.74, "standard_charge_percentage": 56.0000, "estimated_amount": 4211, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 4362.16, "standard_charge_percentage": 58.0000, "estimated_amount": 4362, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 6768.87, "standard_charge_percentage": 90.0000, "estimated_amount": 6768, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 7370.55, "standard_charge_percentage": 98.0000, "estimated_amount": 7370, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 5640.73, "standard_charge_percentage": 75.0000, "estimated_amount": 5640, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 1524.19, "estimated_amount": 1524, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 2819.75, "estimated_amount": 2819, "methodology": "fee schedule" }]}]} , { "description": "Chemodenerv 1 extrem 1-4 ea", "code_information": [ { "code": "38525", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 5683.13, "discounted_cash": 4682,"minimum": 898,"maximum": 5683.13,"payers_information":[{ "payer_name": "UHC", "plan_name": "UHC MO Medicaid", "standard_charge_dollar": 4700.72, "estimated_amount": 4700, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicaid", "plan_name": "Traditional Medicaid", "standard_charge_dollar": 3264.39, "estimated_amount": 3264, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicaid", "standard_charge_dollar": 4733.37, "estimated_amount": 4733, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Commercial", "standard_charge_dollar": 2488, "estimated_amount": 2488, "methodology": "case rate" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Commercial", "standard_charge_dollar": 5114.82, "standard_charge_percentage": 90.0000, "estimated_amount": 5114, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge_dollar": 2273.25, "standard_charge_percentage": 40.0000, "estimated_amount": 2273, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Auto", "standard_charge_dollar": 4546.5, "standard_charge_percentage": 80.0000, "estimated_amount": 4546, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Commercial", "standard_charge_dollar": 5398.97, "standard_charge_percentage": 95.0000, "estimated_amount": 5398, "methodology": "percent of total billed charges" } ,{ "payer_name": "Non-Contracted Commercial", "plan_name": "Non-Contracted Commercials - 80% of BC", "standard_charge_dollar": 4546.5, "standard_charge_percentage": 80.0000, "estimated_amount": 4546, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 3978.19, "standard_charge_percentage": 70.0000, "estimated_amount": 3978, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "Corvel Auto", "standard_charge_dollar": 3978.19, "standard_charge_percentage": 70.0000, "estimated_amount": 3978, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS PPO", "standard_charge_dollar": 3182.55, "standard_charge_percentage": 56.0000, "estimated_amount": 3182, "methodology": "percent of total billed charges" } ,{ "payer_name": "Kansas Superior", "plan_name": "Kansas Superior Select", "standard_charge_dollar": 3674.33, "estimated_amount": 3674, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Exchange", "standard_charge_dollar": 5683.13, "estimated_amount": 5683, "methodology": "fee schedule" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicaid", "plan_name": "Non-Contracted Medicaid", "standard_charge_dollar": 3264.39, "estimated_amount": 3264, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4668.08, "estimated_amount": 4668, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "Anthem Blue Care HMO", "standard_charge_dollar": 898, "estimated_amount": 898, "methodology": "case rate" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 4262.35, "standard_charge_percentage": 75.0000, "estimated_amount": 4262, "methodology": "percent of total billed charges" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Commercial (Primary & Supplemental)", "standard_charge_dollar": 4546.5, "standard_charge_percentage": 80.0000, "estimated_amount": 4546, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 4546.5, "standard_charge_percentage": 80.0000, "estimated_amount": 4546, "methodology": "percent of total billed charges" } ,{ "payer_name": "Valenz Access", "plan_name": "Valenz Access", "standard_charge_dollar": 2841.57, "standard_charge_percentage": 50.0000, "estimated_amount": 2841, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Workers Comp", "standard_charge_dollar": 4546.5, "standard_charge_percentage": 80.0000, "estimated_amount": 4546, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 3409.88, "standard_charge_percentage": 60.0000, "estimated_amount": 3409, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAN HEALTHCARE ALLIANCE", "plan_name": "AMERICAN HEALTHCARE ALLIANCE - Commercial - PPO", "standard_charge_dollar": 4262.35, "standard_charge_percentage": 75.0000, "estimated_amount": 4262, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 5043.19, "estimated_amount": 5043, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3782.39, "estimated_amount": 3782, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Ambetter Sunflower", "standard_charge_dollar": 5683.13, "estimated_amount": 5683, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 5043.19, "estimated_amount": 5043, "methodology": "fee schedule" } ,{ "payer_name": "6 DEGREES", "plan_name": "6 DEGREES - COMMERCIAL", "standard_charge_dollar": 5683.13, "estimated_amount": 5683, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS AUTO", "standard_charge_dollar": 5114.82, "standard_charge_percentage": 90.0000, "estimated_amount": 5114, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Commercial", "standard_charge_dollar": 4972.74, "standard_charge_percentage": 87.5000, "estimated_amount": 4972, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 5683.13, "standard_charge_percentage": 100.0000, "estimated_amount": 5683, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 5683.13, "standard_charge_percentage": 100.0000, "estimated_amount": 5683, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 4546.5, "standard_charge_percentage": 80.0000, "estimated_amount": 4546, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Workers Comp", "standard_charge_dollar": 3978.19, "standard_charge_percentage": 70.0000, "estimated_amount": 3978, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 4262.35, "standard_charge_percentage": 75.0000, "estimated_amount": 4262, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Workers Comp", "standard_charge_dollar": 5114.82, "standard_charge_percentage": 90.0000, "estimated_amount": 5114, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Commercial", "standard_charge_dollar": 5114.82, "standard_charge_percentage": 90.0000, "estimated_amount": 5114, "methodology": "percent of total billed charges" } ,{ "payer_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN)", "plan_name": "AMERICAS CHOICE PROVIDER NETWORK (ACPN) Auto", "standard_charge_dollar": 5569.47, "standard_charge_percentage": 98.0000, "estimated_amount": 5569, "methodology": "percent of total billed charges" } ,{ "payer_name": "Aetna", "plan_name": "Aetna Rental Network", "standard_charge_dollar": 3409.88, "standard_charge_percentage": 60.0000, "estimated_amount": 3409, "methodology": "percent of total billed charges" } ,{ "payer_name": "Veterans Evaluation Services", "plan_name": "Veterans Evaluation Services", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Veterans Choice Program", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 5683.13, "estimated_amount": 5683, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Cigna", "plan_name": "Cigna Healthsprings", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Select", "standard_charge_dollar": 5683.13, "estimated_amount": 5683, "methodology": "fee schedule" } ,{ "payer_name": "TEST UHC", "plan_name": "TEST UHC MO MCD", "standard_charge_dollar": 3446.73, "estimated_amount": 3446, "methodology": "case rate" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1234.81, "estimated_amount": 1234, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE AUTO", "standard_charge_dollar": 4262.35, "standard_charge_percentage": 75.0000, "estimated_amount": 4262, "methodology": "percent of total billed charges" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 5114.82, "standard_charge_percentage": 90.0000, "estimated_amount": 5114, "methodology": "percent of total billed charges" } ,{ "payer_name": "STAR HEALTHCARE ", "plan_name": "STAR HEALTHCARE Commercial PPO", "standard_charge_dollar": 4830.66, "standard_charge_percentage": 85.0000, "estimated_amount": 4830, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER SELECT", "plan_name": "PROVIDER SELECT Workers Comp", "standard_charge_dollar": 4972.74, "standard_charge_percentage": 87.5000, "estimated_amount": 4972, "methodology": "percent of total billed charges" } ,{ "payer_name": "PROVIDER NETWORK OF AMERICA", "plan_name": "PROVIDER NETWORK OF AMERICA Commercial", "standard_charge_dollar": 4546.5, "standard_charge_percentage": 80.0000, "estimated_amount": 4546, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Commercial", "standard_charge_dollar": 4546.5, "standard_charge_percentage": 80.0000, "estimated_amount": 4546, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Auto", "standard_charge_dollar": 4546.5, "standard_charge_percentage": 80.0000, "estimated_amount": 4546, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 1704.94, "standard_charge_percentage": 30.0000, "estimated_amount": 1704, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 4262.35, "standard_charge_percentage": 75.0000, "estimated_amount": 4262, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 4660.17, "standard_charge_percentage": 82.0000, "estimated_amount": 4660, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Freedom Network", "standard_charge_dollar": 3296.22, "standard_charge_percentage": 58.0000, "estimated_amount": 3296, "methodology": "percent of total billed charges" } ,{ "payer_name": "Auto Insurance", "plan_name": "Auto Insurance", "standard_charge_dollar": 4546.5, "standard_charge_percentage": 80.0000, "estimated_amount": 4546, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Home State", "plan_name": "Home State Health Plan Ins Exchange", "standard_charge_dollar": 4863.08, "estimated_amount": 4863, "methodology": "fee schedule" } ,{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicare", "standard_charge_dollar": 3782.39, "estimated_amount": 3782, "methodology": "fee schedule" } ,{ "payer_name": "HEALTH NET FEDERAL SERVICES (TRICARE)", "plan_name": "Healthnet federal services Tricare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" }]}]} , { "description": "Open Bx/Exc Inguinofem Nodes", "code_information": [ { "code": "38531", "type": "CPT" } ], "standard_charges": [ { "setting": "outpatient", "gross_charge": 8542.82, "discounted_cash": 4682,"minimum": 1830.41,"maximum": 8542.82,"payers_information":[{ "payer_name": "Healthy Blue", "plan_name": "Healthy Blue Medicaid", "standard_charge_dollar": 4668.08, "estimated_amount": 4668, "methodology": "fee schedule" } ,{ "payer_name": "THREE RIVERS", "plan_name": "THREE RIVERS Workers Comp", "standard_charge_dollar": 7688.54, "standard_charge_percentage": 90.0000, "estimated_amount": 7688, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Workers Comp", "standard_charge_dollar": 8542.82, "standard_charge_percentage": 100.0000, "estimated_amount": 8542, "methodology": "percent of total billed charges" } ,{ "payer_name": "PRIME HEALTH SERVICES", "plan_name": "PRIME HEALTH SERVICES Auto", "standard_charge_dollar": 8542.82, "standard_charge_percentage": 100.0000, "estimated_amount": 8542, "methodology": "percent of total billed charges" } ,{ "payer_name": "OHA Networks", "plan_name": " OHA NETWORKS WC", "standard_charge_dollar": 5125.69, "standard_charge_percentage": 60.0000, "estimated_amount": 5125, "methodology": "percent of total billed charges" } ,{ "payer_name": "MULTIPLAN", "plan_name": "MULTIPLAN Workers Comp", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "Keenan", "plan_name": "Keenan", "standard_charge_dollar": 2562.85, "standard_charge_percentage": 30.0000, "estimated_amount": 2562, "methodology": "percent of total billed charges" } ,{ "payer_name": "Coventry", "plan_name": "Coventry Workers Comp", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "CORVEL", "plan_name": "CORVEL Commercial", "standard_charge_dollar": 5979.97, "standard_charge_percentage": 70.0000, "estimated_amount": 5979, "methodology": "percent of total billed charges" } ,{ "payer_name": "COMPALLIANCE (FKA COMPRESULTS)", "plan_name": "Compalliance FKA Compresults Workers Compensation", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "BCBS", "plan_name": "BCBS Traditional", "standard_charge_dollar": 7005.11, "standard_charge_percentage": 82.0000, "estimated_amount": 7005, "methodology": "percent of total billed charges" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial Exchange", "standard_charge_dollar": 5043.19, "estimated_amount": 5043, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC Commercial", "standard_charge_dollar": 8542.82, "estimated_amount": 8542, "methodology": "fee schedule" } ,{ "payer_name": "Tricare", "plan_name": "Tricare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Traditional Medicare", "plan_name": "Traditional Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Non-Contracted Medicare", "plan_name": "Non-Contracted Medicare", "standard_charge_dollar": 3602.28, "estimated_amount": 3602, "methodology": "fee schedule" } ,{ "payer_name": "Missouri Medicare", "plan_name": "Missouri Medicare", "standard_charge_dollar": 3782.39, "estimated_amount": 3782, "methodology": "fee schedule" } ,{ "payer_name": "Employer Direct Healthcare", "plan_name": "Employer Direct Healthcare", "standard_charge_dollar": 5043.19, "estimated_amount": 5043, "methodology": "fee schedule" } ,{ "payer_name": "UHC", "plan_name": "UHC KS Medicaid", "standard_charge_dollar": 1830.41, "estimated_amount": 1830, "methodology": "fee schedule" } ,{ "payer_name": "Test KS", "plan_name": "Test KS", "standard_charge_dollar": 1830.41, "estimated_amount": 1830, "methodology": "fee schedule" } ,{ "payer_name": "ZELIS HEALTHCARE", "plan_name": "ZELIS HEALTHCARE FKA STRATOSE Workers Comp", "standard_charge_dollar": 6407.11, "standard_charge_percentage": 75.0000, "estimated_amount": 6407, "methodology": "percent of total billed charges" } ,{ "payer_name": "Workers Compensation", "plan_name": "Workers Compensation", "standard_charge_dollar": 6834.26, "standard_charge_percentage": 80.0000, "estimated_amount": 6834, "methodology": "percent of total billed charges" } ,{ "payer_name": "SELF INSURANCE PLAN OF GREATER KC", "plan_name": "Self Insurance Plan Of Greater KC Commercial", "standard_charge